October 27, 2014

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Sign up Now for Maine Health Action Network (HAN)

The Maine Centers for Disease Control and Prevention urge all Maine physicians to register with the Maine Health Alert Network (HAN).  HAN is a secure, web-based communications system used by the CDC and its Partners to exchange information within and between their respective agencies.

HAN members include physicians, nurses, hospital staff, clinicians, public health workers, emergency preparedness and management personnel, first responders, and many others.

As a physician in Maine, it is important that you are aware of urgent health related information!  Won't you please consider registering?  The registration process will collect some basic information that the system will use to contact you.  Once you have completed the registration process, an administrator will review your registration and notify you once your account is approved.

To Register for the Health Alert Network, go to https://www.mainehan.org/

The Maine CDC also invites all physicians to sign up for their public health update newsletters by e-mailing Tara.Thomas@maine.gov.  



MMA, MHA Present to State's Economic Forecasting Commission

This past Friday, MMA, MHA, and a select group of other professional associations in the state were asked to present information to the state's Economic Forecasting Commission regarding anticipated job and wage growth over the next year and over the next five years.  The non-health care associations invited to present included the Maine Bankers Association, the Maine Auto Dealers Association, Maine Manufacturers Association, and the Maine Oil Dealers Association.

Jeff Austin, on behalf of the Maine Hospital Association, made the following points:

  • Maine Hospitals continued to have a difficult time financially in 2013 with continuing declines in inpatient and outpatient surgery and in ER visits.

  • Operating margins continued to decline, with 21 of 37 hospitals having a negative operating margin.  The numbers from the first quarter of 2014 were even worse, with 23 of 37.

  • That in 2013 total outpatient visits were up 6% and physician visits were up 15%.

  • An  underlying trend in healthcare is a reduction in the acute/high-intensity interventions and a movement to better "management" of chronic conditions, resulting in more office visits but fewer acute care visits and less surgery.

  • Payroll growth in 2012-2013 remained solid at 6%, reflecting employment growth rather than wage growth.  Total FTEs grew 5%.

  • Uncompensated care grew again at a 15% rate.

  • The failure of the state to expand Medicaid under the ACA is expected to cause further deterioration of the hospitals financial position.

Gordon Smith, Esq., EVP of MMA presented following Mr. Austin's presentation and made the following points:

  • There continues to be a shortage of primary care physicians in the state, resulting in the use of more nurse practitioners and physician assistants.  Telemedicine is also becoming more common as a means of dealing with the shortage.

  • There are more than 120 open positions being recruited through the Maine Recruitment Center with additional searches going on, as well.  Most difficult recruits are to primary care in rural areas.  Rural surgeons are also an endangered species.

  • The demand for healthcare in the state is almost insatiable, a combination of being the oldest population in the country and a cultural bias toward medicine being able to fix anything, at any age.

  • Improved coverage will enhance demand.

  • Wages continue to increase or at least remain stable because of the basic law of supply and demand.

  • That while there is certainly consolidation in the hospital world and some in the physician world, there are also still a few hundred physicians practicing in small or solo practice.  In addition, more than 400 physicians are in larger private groups such as Spectrum Medical Group, Martin's Point Health Care, and Intermed.

The purpose of the Commission is to provide expert economic analysis regarding the state's economy to the Legislature and Executive branch.

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Planning for 127th Maine Legislature by MMA Legislative Committee Will Take Place November 18th

Election Day is next week and the 127th Maine Legislature's composition will be decided that day, barring any recounts of course.  On the evening of Tuesday, November 18th, the MMA Legislative Committee, chaired by Amy Madden, M.D., will meet at the Frank O. Stred Building in Manchester to prepare for the coming legislative session.  The meeting will begin with dinner at 6:00 p.m.  We will begin the substantive part of the meeting between 6:15 and 6:30 p.m. and will conclude by 8:30.  The agenda will include a review of election results and leadership races in the new Maine legislature and discussion of known or potential legislative initiatives for the coming session from the MMA, medical specialty societies, other health care advocacy organizations, as well as potential threats for organized medicine.  Any Maine physician who is interested in MMA's advocacy work is welcome to attend and medical specialty organizations are strongly encouraged to send one or more representatives to participate in the discussion.  The MMA staff and leadership will refine the organization's legislative agenda between this meeting and the "cloture deadline" or deadline for legislators to submit bills which is usually some time in mid-December.

We welcome participation by all, but please RSVP to Ashley Bernier (abernier@mainemed.com; 622-3374, ext. 213) so we can plan adequately for food.  For more information about the meeting, please contact Andrew MacLean, Deputy EVP & General Counsel at amaclean@mainemed.com or 622-3374, ext. 214. [return to top]

Get Covered, Stay Covered - Health Insurance Marketplace Update

Open Enrollment for health insurance through the Marketplace begins on November 15th and ends on February 15, 2015.  Patients should enroll or renew between November 15th and December 15th for coverage to begin on January 1, 2015.

Important information for your patients who have 2014 insurance coverage through the Marketplace - 5 Steps to Staying Covered Through the Marketplace: Review, update compare, choose and enroll.

Marketplace assistance is available by phone, online and in-person.  Some people will have questions about applying for health insurance and about plans available through the Marketplace.

  • Assistance is available by phone at the Marketplace Call Center 1-800-318-2596 and online at www.healthcare.gov.

  • In Maine, consumers can go to www.enroll207.com to search for free in-person assistance by zip code.

  • They can also call the Maine Helpline at 1-800-965-7476 with questions and to get help with applications.

For more information, resources for your patients, or training for your practice, contact ACA Outreach Coordinator Sue Kring at skring@mainemed.com or 662-2364.


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November 7, Free First Friday Seminar on Opiate Limits and Application of Health Information Technology

November 7, 2014 at the Maine Medical Association - Please register on-line at www.mainemed.com!  The Program is being offered free of charge.



To promote the use of Health Information Technology (i.e. PMP, HIE & SBIRT) to assist health care providers throughout Maine in achieving easier access to comprehensive patient data to assist them in providing integrated, effective & efficient patient treatment..  And to inform attendees of the experience in the MaineCare program of the Jan. 1, 2013 prior authorization requirements on opioid-based medication.


8:30 AM     Registration
9:00           MaineCare and Opioids Dr. Kevin Flanigan
10:00         Break
10:10         PMP/HIN Phil Profenno, PMP & Eriko Farnsworth
11:00          Panel session and Q&A
12:00         Adjourn


Philip Profenno, PMP, Director of Implementation and Client Services is Director of Implementation and Client Services at HealthInfoNet and responsible for connecting participants to the exchange, including data integration, clinical portal access, user training and education. He has been an IT Professional serving Maine healthcare organizations for over 20 years with extensive experience implementing practice management and electronic medical records systems. Phil holds a Bachelor of Arts in Mathematics from Bowdoin College and is certified as a Project Management Professional with the Project Management Institute.

Kevin Flanigan, MD is the medical director of MaineCare, the state’s Medicaid program for low-income and disabled adults and children. Among Dr. Flanigan’s goals are reducing the use of hospital emergency departments for nonemergency care and enhancing MaineCare’s statewide care management efforts. Dr. Flanigan is a graduate of the University of Richmond and the Medical College of Virginia in Richmond, Va. He completed an internship and residency at the University of Louisville Hospital in Kentucky, with concentrations in pediatrics and internal medicine. He continues to study at the University of Massachusetts at Amherst and serves in a leadership role with the Maine Medical Association. He first was licensed in Maine in 1997 and has worked in primary care, urgent care and hospital settings.

Eriko Farnsworth is managing the Prescription Monitoring Program’s integration and interoperability projects which include interstate PMP data exchange, integrating state’s health information exchange and other health networks with the PMP. She also oversees PMP data integrity and pharmacy compliance. She is currently involved with various in-state and nationwide committees and leadership groups helping to nationalize and standardize the PMP programs throughout the United States. Eriko’s background in law as well as in behavioral health gives her a unique perspective and insight into enhancing, promoting and increasing PMP utilization for efficient use of health information technology to improve patient care.

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U.S. Supreme Court Recently Hears Oral Arguments in Patient Safety Case

The nation's highest court recently heard arguments in a case that will decide whether the Federal Trade Commission (FTC) can second-guess the work of state medical licensure boards. 

The Supreme Court of the United States recently heard oral arguments in North Carolina State Board of Dental Examiners v. FTC, a case previously decided by a federal appeals court that ruled in favor of the FTC's claim that state licensure boards should be subject to federal antitrust laws.  The decision of the appeals court could effectively limit the ability of these boards to regulate their health care professions and shield patients from unlawful practices.

The AMA and other health care organizations filed an amicus brief expressing support for the plaintiffs in this case, stating fear that if the court ruled for the FTC, it would have a chilling effect on state medical and dental boards to the detriment of public health.

In June, physicians at the open forum of the Litigation Center of the AMA and State Medical Societies heard both sides of the case argued in a mock court session.
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MMA and Board of Licensure in Medicine Present REMS Course on Saturday, Nov. 15 at Maine General and on the Web

The Maine Medical Association and the Maine Board of Licensure in Medicine are sponsoring a three-hour CME course on extended-release opioid analgesics on Saturday, November 15, 2014.  The course will be presented from 9:00 am to noon at MaineGeneral Medical Center but can be accessed through the web via webex as well. But the webex connection is available to only 25 remote sites so register ASAP.  Registration is available on the MMA website at www.mainemed.com.  The cost of the program is just $15 for those physicians attending in Augusta (who will receive breakfast) and the program is free for those registering and participating through webex. 

The faculty for this Risk Evaluation and Mitigation Strategy are Noah Nesin, M.D., FAAFP, Chief Medical Officer at Penobscot Community Health Center and Elisabeth Fowlie Mock, M.D., M.P.H., past president of the Maine AFP and an academic detailer for MMA.

Any questions about the course can be directed to Gail Begin via e-mail to gbegin@mainemed.com or by calling Gail at 485-1341.

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Four Key Changes Needed for EHR Meaningful Use Program

Challenges with electronic health record (EHR) systems are widespread, and the meaningful use program has only compounded those problems.  Physicians recently called on the government to make four essential changes to meaningful use so EHR technology can become a tool for practice efficiency and enhanced patient care.

In a 31-page comment letter (log in) submitted recently to the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT, the AMA provided a blueprint for the future of the meaningful use program ahead of the announcement of Stage 3 requirements expected later this year.

The four chief changes the letter outlines are:

1. Adopting a more flexible approach for meeting meaningful use.  Among the components the letter identifies for achieving this flexibility are eliminating the concept of menu versus core requirements, revising the measures list to meet the needs of specialists and requiring physicians to meet no more than 10 measures under Stage 3. 

The letter also reiterates the AMA's recommendation that CMS abandon the program's all-or-nothing approach by adopting a 50 percent threshold for incurring a penalty and a 75 percent threshold for earning an incentive in Stages 1 and 2.

Making the program more flexible "will also help mitigate challenges physicians are facing from factors outside of their control, such as EHR interoperability, usability issues and meeting measures that are contingent upon patient action," the letter states.

2. Expanding hardship exemptions for all stages.  Eligibility for an exemption for quality measures should include successful participation in the Physician Quality Reporting System and a broader list of "unforeseen circumstances" that prevent physicians from meeting meaningful use requirements.  The letter also calls for exemptions for physicians close to retirement and hospitalists, who have little control over the technology available to them.

Note: If your practice needs a hardship exemption for 2014, CMS recently announced that physicians have until Nov. 30 to apply.

3. Improving quality reporting.  In particular, the letter urges CMS to build a sufficient quality infrastructure and continue to allow physicians to report on a menu of quality measures. 

The letter also stresses that EHRs must be made interoperable so physicians can focus more on outcomes and longitudinal tracking of patient care.  That includes developing standards for sharing data between EHRs and clinical data registries.

4. Addressing physician EHR usability challenges.  Citing the increasing dissatisfaction with this technology as evidenced in the AMA-RAND study released last year, the letter points to how today's EHRs are characterized by poor usability, time-consuming data entry, interference with face-to-face patient care, insufficient health information exchange and degradation of clinical documentation. 

"There is growing awareness across stakeholders that the meaningful use vendor certification process should be streamlined to enable higher performing products that focus on interoperability, quality measurement reporting and privacy/security," the letter states. 

In addition, "EHRs should facilitate interoperability among various facilities that comprise our health care system, including hospital inpatient, ambulatory settings, lab and pharmacies."

The AMA's advocacy on this topic is supported by a new framework (log in) for EHR usability released last month. Developed by the AMA and an external advisory committee of practicing physicians and health IT experts, researchers and executives, the framework offers eight top challenges and solutions that can leverage the potential of EHRs to enhance patient care, improve productivity and reduce administrative costs.
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AMA Assembles Ebola Resources for Physicians and Public

The Centers for Disease Control and Prevention (CDC) on Sept. 30 confirmed the first U.S. case of Ebola, and developments associated with the virus continue to unfold. Prepare your practice and your patients with resources developed by Ebola experts and assembled by the AMA in one convenient location.

Visit the AMA's online Ebola Resource Center for information from the CDC and other public health groups. Resources cover:

  • Understanding the virus
  • Preparing your hospital or practice
  • Screening and diagnosing Ebola
  • Treating patients with the virus

The resource center will be updated regularly to give you, your practice staff and your patients the most up to date information you need. Save ama-assn.org/go/ebola to your favorites for an easy reference.

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PQRS Incentive Payments Now Available

Incentive payments for the Physician Quality Reporting System (PQRS) now are available for eligible professionals and group practices who successfully met the program's reporting criteria for Medicare Physician Fee Schedule Part B services furnished in 2013. 

Physicians can access their 2013 feedback reports in two ways:

  • National Provider Identifier (NPI)-level reports. These reports can be requested through the CMS communication support page by creating an NPI-level feedback report request.  The report will be sent electronically in two to four weeks to the email address provided in the request.
  • Taxpayer Identification Number (TIN)-level reports. These reports contain NPI-level detail and are available for download via CMS' quality reporting portal.  An "Individuals Authorized to Access CMS Computer Services" (IACS) account is required to access a TIN-level report through the portal. To request an IACS account, consult the IACS quick references guides

For more information about the PQRS incentive payments, review CMS' analysis and paymentWeb page.  For more information about interpreting the data in the report, view the 2013 PQRS feedback report user guide or the 2013 eRx incentive program feedback report user guide

Physicians can contact the QualityNet Help Desk for assistance 8 a.m.-8 p.m. Eastern time Monday through Friday at (866) 288-8912 or qnetsupport@hcqis.org.

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Upcoming Events


 Webinar:  Get Covered, Stay Covered: Looking Ahead to Open Enrollment 2015

October 28, 2014, 12-1pm, Quality Counts Brown Bag Forum

Information for health care providers, practice staff, and the community. Learn about duties, deadlines, and where to go for help. Join us to hear what we've learned and what to expect during Open Enrollment 2014-2015.

Register online here.



Join your colleagues for the Maine CRC Round Table onNovember 17th and help Maine reach an 80% colorectal cancer screening rate by 2018!

The American Cancer Society, The Maine Cancer Consortium and The Maine CDC Colorectal Cancer Control Program invite you to prevent more colon cancers and save more lives. We value your knowledge about colon cancer screening and encourage you to participate in our collaborative.

Please Join Us for Breakfast and Discussion

  • To better assess colorectal cancer screening rates in Maine
  • To identify significant barriers to colon cancer screening in Maine
  • To form partnerships in an effort to improve colon cancer screening rates statewide.

Dates & Times:

November 17, 2014

8:30am -10am at the Senator Inn in Augusta

8:15am check-in

8:30am program begins

Please RSVP

For more information, please contact
Terry.Baker@cancer.org or (207) 373-3716

We look forward to seeing you!

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Job Openings

Family Nurse Practitioner

Sacopee Valley Health Center is recruiting a Family Nurse Practitioner to provide walk-in care on Fridays, Saturdays and Sundays.  This 30 hour per week position involves no after-hours call with an excellent benefit package including health, disability and life insurance, 401k retirement plan, and a generous paid time off plan. Applicants must be a graduate of a Family Nurse Practitioner Program with current Maine licensure. Please submit resume to nbuck@svhc.org or mail to:  Human Resources Coordinator, Sacopee Valley Health Center, 70 Main Street, Porter, Maine 04068. Sacopee Valley Health Center is an Equal Opportunity Provider and Employer.


Seeking Physicians (Non Behavioral Health) to Participate in Ongoing Committees with MCHO

Maine Community Health Options (MCHO) is seeking physicians (Non Behavioral Health) to participate in ongoing committees with MCHO. 

Available committee roles are:

  1. Credentialing Committee
    • One specialty
    • One primary care physician (MD/DO)
Credentialing files are sent electronically for review prior to the meeting and participation can be in person or remotely. Meets once a month and the stipend is $250 for each meeting.
  1. Medical Management Committee
  • Two specialty physicians (MD/DO)
Agenda items are sent electronically for review.  Meets quarterly and can be attended remotely or in person.  Stipend is $250 for each meeting.
  1. Quality Assurance Committee
    • Two specialty physicians (MD/DO)
Agenda items are sent electronically for review.  Meets quarterly and can be attended remotely or in person.  Stipend is $250 for each meeting.
The physician committee members must hold an active, unrestricted license to practice medicine and be board certified (if applicable) by:
  • A specialty board approved by the American Board of Medical Specialties (doctors of medicine); or
  • The Advisory Board of Osteopathic Specialist from the major areas of clinical services (doctors of osteopathic medicine)

Please contact John Yindra Jyindra@maineoptions.org or 207-402-3327 for more information.


Family Practice Physicians

Katahdin Valley Health Center is recruiting dedicated Family Practice Physicians that are committed to providing quality health care services to the people in Central/Northern Maine.  Join our practice in one of the newly expanded facilities.  We are seeking physicians for our Millinocket, Ashland and Houlton locations.  KVHC is a fully electronic medical record site and offers a competitive salary ($170,000 to $190,000 annual) and benefit package which includes: a 10% of first year salary sign on bonus, generous amounts of paid time off, $2500 annually toward CME as well as a completely outpatient site.  The call schedule is 1 in 8 with additional coverage from the Open Access Clinic.  Physicians who join KVHC are eligible to apply for NHSC Loan Repayment.

To learn more about KVHC and Practitioner Opportunities, please contact Michelle LeFay at mlefay@kvhc.org or visit our website at www.kvhc.org.  KVHC is an equal opportunity employer.






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