August 11, 2014

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CMS Delays Public Launch of Open Payments System

The Centers for Medicare and Medicaid Services last week issued a statement saying it will delay publicly launching its new database intended to disclose potential conflicts of interest among physicians and that the open payments system was temporarily taken offline to investigate a data mix-up.

The Open Payments System listing payments from drug and medical device manufacturers to physicians was scheduled to go public on September 30th after physicians and teaching hospitals were given until August 27th to review the information reported about them and dispute anything they believed to be incorrect.

The data mix-up involved a situation where at least one physician was able to see the payment data for another physician whose records were erroneously linked.  

For each day offline, CMS will adjust the open payments 45 day physician review period accordingly.  

In an August 5th letter to CMS, 108 medical associations and medical specialty societies, including the Maine Medical Association, expressed serious concern with its implementation.  We urged CMS to extend both the review deadline and the public launch date and urged CMS to make other changes, including an exclusion related to CME and to reconsider its decision not to cover medical text books, journal article supplements, and reprints within the existing statutory exclusions for educational materials that directly benefit patients.

The AMA says that physicians have reported various problems with the review and dispute process, including:

  •  a requirement to create a registration profile on the CMS Enterprise Portal before registering for the Open Payments program, which takes several steps and involves the submission of detailed personal information;
  • no clear guidance on where to go to register in the Open Payments system;
  • an Open Payments registration process that takes at least 30 minutes and has taken some physicians more than 2 hours;
  • a requirement that the Open Payments registration process be completed in one sitting, with no data saved if a physician comes back to the process later; and
  • a requirement that registrations can only be done using the Internet Explorer browser.


Also, some physicians have completed their registrations, attempted to review their information, and received error messages.

MMA Seeking Volunteers for Committees and Board of Directors

The MMA Committee on Nominations, chaired by Kenneth Christian, M.D. of Holden, will meet via conference call on August 21st to prepare the final list of nominations for MMA committees and the Board of Directors for presentation at the Annual Meeting on September 6th at the Bar Harbor Club in Bar Harbor (adjacent to the Harborside Hotel and Marina).  Members willing to consider serving on an MMA committee or on the Board of Directors should communicate by the 21st to Gordon Smith, MMA EVP via e-mail to or by calling Gordon at 215-7461 (cell).  Information on the committees can be found on the MMA website at  

During the next 12 months there will be many important decisions made about health care, both in the nation and in Maine.  MMA would welcome your active involvement as the Association works hard to represent the needs of Maine physicians.



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Still Time to Register for MMA's 161st Annual Session in Bar Harbor

 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 has closed, but there are plenty of alternative accommodations in downtown Bar Harbor.  You can find information about the meeting, including registration information, the agenda, and hotel reservation information on the MMA web site here.  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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U.S. House and Senate Recess for Remainder of August

Despite mounting pressure to stay in session and do some compelling business, the U.S. Congress recessed last week for a month-long summer recess and is not expected to return to Washington until September 8th. After a relatively short time, lawmakers are expected to adjourn again for the election season and return for a lame duck session following the election.  Physicians and medical organizations will be talking with our Maine Congressional delegation about the need to permanently repeal the SGR formula for Medicare reimbursement. The current temporary fix expires on March 31, 2015. [return to top]

Final Rule on Voluntary EHR Certification in 2015 Nearly Complete

The Office of the National Coordinator for Health IT (ONC) on August 1st sent to the White House Office of Management & Budget (OMB) for review, a final rule to update for 2015 the ONC's voluntary criteria for its EHR certification program.  The ONC published a proposed rule on February 26th (79 Fed. Reg. 10,880) and that was the first time that the ONC had released EHR certification criteria separate from "meaningful use" rulemaking overseen by CMS.  [return to top]

FSMB to Release Interstate Medical Licensure Compact by October

On August 1st, the Federation of State Medical Boards (FSMB) announced that it plans to release a final version of its proposed Interstate Medical Licensure Compact that would make it easier for physicians licensed in one state to practice in another, both in-person and via telemedicine.  The Compact is designed to make physician licensure portable among states that adopt it.  The FSMB House of Delegates has strongly endorsed this effort.  The FSMB expects at least 15 states to adopt the Compact in 2015 and 2016 and medical licensing boards in Texas, Oklahoma, and Washington already have agreed to support the Compact. 

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EHR Adoption Continues to Grow, but Providers not Using IT to Improve Care RWJF Says

At a briefing by the Robert Wood Johnson Foundation on August 7th, researchers and regulators said that hospitals and physicians continue to increase their use of electronic health records, but relatively few of them are using them to share patient information or to improve the quality of care.  Since the 2011 beginning of the "meaningful use" incentive program, the adoption of EHRs has grown 10% each year for hospitals and nearly 10% per year for other providers.  In 2013, 78% of office-based physicians had adopted an EHR system and nearly 60% of hospitals had done so.  However, fewer than 15% of providers had used their EHR systems to exchange patient information with another provider electronically.  The study included hospitals with at least a basic EHR system in place which accounted for 59% of hospitals in 2013.  Of the hospitals in the study, 77% had established a dashboard with factors to measure organizational performance while fewer than 66% had established dashboards for measurement of individual practitioner performance.  Fifty-two percent of hospitals in the study were using EHRs to identify gaps in the care they provide and 54% were using their EHRs to identify high-risk patients.  Just half of the hospitals studied permitted their clinicians to query EHR data for clinical research.  The study is to be published in the September issue of Health Affairs. [return to top]

8 Things You Should Know About Medicare's Proposed Payment Rule

If the policies set forth in the 2015 Medicare Physician Fee Schedule proposed rule take effect, physicians will be in for a lot of changes—many of them unfavorable—next year.  Here are the top eight things that should be on your radar:

1.  A 21 percent payment cut is scheduled for April 1.  The Centers for Medicare & Medicaid Services (CMS) observed in a fact sheet that current payment rates will apply through March as a result of the temporary payment patch enacted earlier this year and projected that payment rates will be cut by 20.9 percent April 1 unless Congress intervenes.  The agency stated its support for repeal of the flawed sustainable growth rate formula that has triggered such large cuts.

2.  Global surgical packages will be eliminated.  The rule proposes to discontinue all 10-day global surgical packages by 2017 and 90-day packages the following year.  Packages instead would include only preoperative care and care given the day of surgery. Consistent with longstanding AMA policy, the AMA plans to work with the affected medical specialty societies to protest this proposed change.

3.  Payments will be adjusted by the Value-Based Payment Modifier beginning next year.  Despite continued AMA opposition, CMS plans to levy steeper payment adjustments and to continue basing the adjustments on costs and quality data two years before the adjustment is applied.  Physicians in groups of 100 or more will see payment penalties or bonuses next year, determined by their group's cost and quality performance in 2013. Bonuses and penalties based on 2014 performance will be applied to groups of 25-100 starting in 2016. 

All physicians will be subject to the modifier beginning in 2017, at which point the potential penalty will double to 4 percent.  The pool of money available for bonuses depends on how much is collected in penalties, so potential bonuses are not yet known. 

4. Quality reporting requirements will be increased in the face of penalties.  CMS has reiterated a 2 percent payment penalty for physicians who don't meet the 2015 Physician Quality Reporting System (PQRS) requirements and is proposing additional requirements physicians will need to fulfill.  At the same time, the agency is proposing to cut the period physicians have to request an informal review of a PQRS penalty from 90 days to just 30 days.

5.  PQRS data will be publicly reported.  The rule proposes making all 2015 measure data from group practices available in 2016.  The agency also is hoping it will be able to publish later that year individual measures for all physicians on Physician Compare, a website plagued by accuracy and usability problems since it launched in 2010.

6.  Chronic care management services will be covered.  Beginning next year, Medicare will pay $43.67 per patient per month for chronic care management provided by a physician's office and $32.58 for care provided by a facility.  Such services involve non-face-to-face care coordination for patients with multiple serious chronic conditions that are expected to last at least 12 months or until death.

7.  More telehealth services will be covered beginning in 2016.  The proposed changes include greater access for patients in rural locations by expanding the number of rural sites.

8.  A new timeline for changing physician codes and service values would take effect in 2016.  This revised timeline will mean physicians can submit recommendations no later than Jan. 15 for the following year.  The change not only will severely limit recommendations from the Relative Value Scale Update Committee (RUC) and CPT® Editorial Panel but also will increase the time for a new or revised code to be included in the Medicare fee schedule from 10-20 months to 20-27 months.  The AMA already has suggested timeline revisions to CMS that would provide greater transparency and better alignment between relative value unit recommendations and the regulatory process. 

Comments on the proposed rule are due September 2nd.  The AMA will circulate its draft comments to state and specialty medical associations in advance of the submission deadline.
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Job Openings


A progressive 25-bed critical access hospital in central Maine is seeking a FP to join their employed primary care group.  This is a full time opportunity which consists of 32 patient contact hours per week, allowing time to enjoy what this region of Maine has to offer! 

Sebasticook Valley Health (SVH) in Pittsfield, Maine is an integral member of the communities it serves. SVH takes a proactive approach in helping people in the Sebasticook Valley improve the quality of their lives.  SVH serves an area of approximately 30,000 people and has a wide range of outpatient services, including over 20 specialty services.  SVH is a proud member of the Eastern Maine Healthcare Systems which ensures access to high quality care to Maine residents and visitors.

For Further Information, please contact:

Sherry Tardy, Director Business Development/Provider Recruitment
Sebasticook Valley Hospital
447 North Main Street
Pittsfield, ME  04967

By email at: or by phone at: 207-487-4085


Physician Opportunities at Mayo Regional Hospital

Live and work in the beautiful Maine Highlands between Moosehead Lake and Bangor. Mayo Regional Hospital currently has the following physician opportunities:  Family Practice, Outpatient IM, OBGYN, Hospitalist, Emergency Department. Also, Family Practice PA & NP and Psych NP openings. Exceptional schools and a wonderful rural setting with proximity to Bangor and Orono.

Contact Brad Clark, Director of Provider Recruitment or 207-564-4342.


Gastroenterologist Jobs in Central Maine!

Challenging, Lucrative, Gastroenterologist jobs in central Maine - honoring and serving Veterans. Gastroenterologists 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 Gastroenterology by the appropriate accrediting agencies required.

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.


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  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



Health Care (HC4ME) For Maine

2nd Annual Health Care for Maine Conference

"Successfully Implementing the ACA in Maine"

Keynote Speaker:  Ron Pollack, Founding Executive Director of Families USA

Tuesday, September 16, 2014 from 8:30 a.m. to 4:00 p.m.

Augusta Civic Center

Agenda and registration available on the Consumers for Affordable Healthcare website


Direct Primary Care (DPC) Workshop

with Dr. Brian Forest, Founder, Access Healthcare Direct & AAFP DPC Workgroup Leader

& Maine physicians developing an integrated Maine Direct Care Network for existing practices

 Calling Doctors & Consumers: Come explore the options.

September 26, 1-5pm and September 27, 8:30-12:30pm,  2014

Maine Medical Association, Manchester

For further information email


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,, (207) 577-2018

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