November 17, 2014

 
Subscribe to Maine Medicine eNewsletters
Manage Your Subscriptions
Email our Editor...
Maine Medical Association Home Page
. Search back issues
. Plain Text Version
Printer Friendly

Health Insurance Marketplace Open Enrollment Began Saturday, Nov. 15

The ACA's Health Insurance Marketplace opened for its second open enrollment period on Saturday.  The healthcare.gov site performed better than last year and HHS stated late Saturday that 100,000 individuals had enrolled in the 37 states, including Maine, that rely on the federal exchange.  The open enrollment period last only three months, ending on Feb. 15, 2015.  

This year, the penalty for not being covered is either 2% of  yearly income or $325, whichever is greater.  There are, however, a number of exceptions to the mandatory coverage.

A one-page Guide to the Marketplace is available here.  Consumers can now review their plan options for 2015 here.  Consumers who have 2014 insurance coverage through the Marketplace are advised to review, update, compare, choose and enroll for 2015 coverage: 5 Steps to Staying Covered Through the Marketplace.

Enrollment assistance is available by phone, online, and in-person.  

  • 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 Consumers for Affordable Care 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.

Nationwide, the pool of potential enrollees is an estimated 23 to 27 million people who don't have access to affordable coverage through employment.  Premiums have seen only modest increases since last year, the result partially of more insurers participating in the exchange.  In Maine, Harvard Pilgrim Health Care has joined Anthem and Maine Community Health Options in offering plans on the exchange.

 

 

Maine VA now Reporting to Prescription Monitoring Program

Maine's decade old Prescription Monitoring Program (PMP) is now receiving reports daily from the Veterans Administration.  The reporting is prospective only and began on October 30, 2014.  Reports on veterans receiving prescriptions for scheduled drugs were not reported previously as federal law prohibited such reports. The federal law was changed recently and the reports are now being received.

The PMP still does not receive the reports of methadone being dispensed at federally-licensed facilities.  Such reporting would also require a change in federal law.

[return to top]

MMA's October 2014 Member Survey Results

The MMA aims to survey the membership quarterly using the SurveyMonkey tool to determine physicians' opinions on a variety of current topics in medicine, law, policy, and politics.  The following are the three questions asked in October and the results.

 Question 1:  Do you think the Maine Legislature should enact legislation requiring pseudoephedrine to be sold by prescription?  (182 individuals responded; 3 did not)

 Answer:  Yes (57 or 31.32%); No (125 or 68.68%)

 

Question 2:  Do you think the Maine Workers' Compensation Board should impose limits on opiate-based medication similar to those adopted by MaineCare?  (180 individuals responded; 5 did not)

 Answer:  Yes (103 or 57.22%); No (77 or 42.78%)

 

Question 3:  Do you support having a separate licensing board for Physician Assistants, who are now licensed through either the Board of Licensure in Medicine or the Board of Osteopathic Licensure, or both, depending on the supervising physician?  (177 individuals responded; 8 did not)

Answer:  Yes (63 or 35.59%); No (114 or 64.41%)

  [return to top]

Value-Based Care Workshop for Clinicians, Dec. 17, Hilton Garden Inn, Freeport

With funding provided by the Maine Health Access Foundation (MeHAF), the MMA is pleased to present this workshop on value-based care at the Hilton Garden Inn in Freeport.

5:30 Reception

6:00 Dinner

6:30 Workshop

8:30 Adjournment

 

Clinicians are being held more and more accountable for performance. While most agree there is room for improvement, the best manner for clinicians to assume responsibility is yet to be determined. This interactive workshop will cover best practices for combining leadership directives and clinical insights to create homegrown value improvement initiatives that lead to better care at lower costs.  

A one-page overview of the workshop is available for downloading here.

PRESENTERS:

Neel Shah, MD, MPP, is the Executive Director of Costs of Care, an Assistant Professor at Harvard Medical School, and a practicing obstetrician/gynecologist at Beth Israel Deaconess Medical Center. He has been named one of the “40 smartest people in healthcare” by Becker’s Hospital Review for his efforts to support clinicians in delivering value-based care, and senior author of the textbook Understanding Value-Based Care (McGraw-Hill).

September Wallingford, RN, is Director of Nursing Initiatives at Costs of Care and a practicing registered nurse at Brigham & Women’s Hospital.

REGISTRATION:

Register by Dec. 12 please by emailing abernier@mainemed.com. There is no fee to attend thanks to an educational grant from the Maine Health Access Foundation to engage physicians in payment reform. An application for 2 hours category 1 AMA CME credit is pending.

 

 

[return to top]

Eastern Maine Health Care and Anthem Create Accountable Care Organization for 40,000 Patients

Last week, Anthem Blue Cross and Blue Shield and Eastern Maine Healthcare Systems announced that they had formed an Accountable Care Organization (ACO) designed to avoid cost increases in healthcare services provided to approximately 40,000 patients in northern and eastern Maine.  The organization will involve 15 hospitals and 405 primary care practitioners from 114 practices throughout the state.  Anthem already has an Accountable Care Organization with MaineHealth, the parent organization of the Maine Medical Center in Portland.

In an accountable care organization, insurers and providers work together to provide more preventive services and to better manage chronic conditions.  If they are successful and costs are reduced, the savings are shared.  If, however, the costs still increase, the providers are penalized.  EMHC has some experience in the ACO world through its previous Beacon ACO which had a three -ear contract with Medicare.

ACOs normally move away from fee-for-service payments and instead pay the provider for managing the health of a specified population.  Typically, the population is managed by a team of care-givers who more actively monitor the patient and may work with community care teams.

 

 

[return to top]

MMA and Baystate Financial Offer Free Education Event Nov. 19 on Planning for Retirement

MMA and Baystate Financial will present a program for health professionals and spouses on Nov. 19th at the Falmouth Country Club (1 Congressional Drive, Falmouth).  Entitled, Retirement Income Distribution Strategies:  Avoiding the Potholes in Retirement, the program will be presented from 6:00 to 8:00 pm.  Light appetizers will be provided.

 This educational seminar will provide guidance on:

  • Maximizing your cash flow;

  • Reducing investment risk;

  • Minimizing income tax; and

  • Maximizing social security.

As a general rule, people have a tendency not to focus on distribution planning until they are almost ready to retire which is way too late and a big mistake.  In this workshop, you will learn why that's the case.  This workshop focuses on the issues and risks associated with converting retirement capital into a dependable retirement income.  You will learn about the importance of making your income last for a lifetime as well as the difference between tax deferral and tax diversification.  In addition, you will learn the importance of measuring retirement success by the income you create and not necessarily by the level of wealth you create.  And finally, you will learn the importance of managing risk all along the way.

To register, contact Brian Falconer at bfalconer@baystatefinancial.com or by calling 401-432-8836.

 

[return to top]

MMA Partners with NAMI-Maine on Suicide Prevention

The Maine Medical Association is working with the Maine Chapter of the National Alliance for the Mentally Ill (NAMI-Maine) to train medical providers around suicide awareness and prevention.  There are several opportunities for practices to participate in this offering, and the majority of them provide CME credit for participation.

Eight practices will receive complimentary training for their staff on the Suicide Prevention in Primary Care Toolkit which was developed by the Suicide Prevention Resource Center and the Western Interstate Commission of Higher Education’s Mental Health Program.

Other offerings include:

  • Suicide Prevention Gatekeeper training for practice staff;
  • Clinical Assessment Lunch and Learn for Clinical practice staff;
  • Clinical Assessment Lunch and Learn for Behavioral Health staff; and
  • Technical Assistance to support practice integration of suicide screening, protocol development, and practice flow needs.

For more information about any of these options, please call Dee Kerry deHaas at the Maine Medical Association:  207-622-3374 x219 or email her at ddehaas@mainemed.com

  [return to top]

MMAs December 5th First Fridays Program: Annual Compliance Seminar

MMA Annual Compliance Seminar

AGENDA (Registration Form) 8:30 AM Registration

9:00 Introductions and HIPAA Update, Gordon Smith, Esq.

9:30 OSHA, including Bloodborne Pathogen Rule, Stacy Doten, RN

10:00 Employment Law Update, Michael Burian, Esq.

10:30 Break

10:45 Fraud and Abuse Update, Andrew MacLean, Esq.

11:30 Q & A

12:00 Adjourn

 OBJECTIVES

1.    To inform attendees of the new laws and regulations impacting on the operation of a medical practice.

2.    To specifically deal with laws and regulations regarding OSHA, Employment, Fraud and Abuse (ACA enhanced) and HIPAA.

3.    To demonstrate how risk of non-compliance can be reduced.

FACULTY

Michael Burian, Esq. joined Kozak & Gayer as an associate in 2010, and he maintains a general health care law practice assisting various types of health care entities. While in law school, Mike was an editor of the Maine Law Review and practiced as a student attorney for the Cumberland Legal Aid Clinic and the Maine Disability Rights Center. He also completed internships at the Maine Office of the Attorney General and the U.S. Attorney’s Office in Portland. Prior to law school, Mike was an AmeriCorps VISTA working for Wyoming Legal Services in Lander, Wyoming.

Stacey P. Doten, RN, CPHQ, HACP is a Senior Risk Manager with Medical Mutual Insurance Company of Maine. She has Associate Degrees in both Laboratory Science from the University of Maine at Augusta and Nursing from Northern Maine Community College. She has more than 20 years of healthcare experience, including healthcare quality and risk management. She is a Certified Professional in Healthcare Quality (CPHQ) and a Certified Professional in Healthcare Accreditation (HACP). She is a member of the Northern New England Society for Healthcare Risk Management (NNESHRM), National Association of Healthcare Quality (NAHQ), and the Maine Medical Group Management Association (MEMGMA).

Gordon H. Smith, Esq. is the Executive Vice President of the Maine Medical Association and has served Maine’s physicians since 1979. He is a native of Winthrop, Maine and a graduate of the University of Maine and Boston College Law School.

Andrew B. MacLean, Esq. is the Deputy Executive Vice President & General Counsel of the Maine Medical Association.  He provides health law and general legal advice to the Association. Mr. MacLean is an experienced health care attorney and lobbyist. He served six years as Mayor of the City of Gardiner and four years on active duty as a U.S. Marine Corps officer.  He is a graduate of Duke University and the University of Maine School of Law.  Disclosure: No significant or relevant financial disclosures.

  [return to top]

AMA Leads State/Specialty Societies in Pushing for SGR Fix During Lame Duck Session

The AMA, along with state medical societies and national specialty organizations, is pressing Congress for a "permanent fix" to the Medicare SGR payment problem during the lame duck session taking place now.  The most recent patch expires on March 31, 2015.  The next scheduled cut would be 21%.  AMA President Robert Wah, M.D. said in a blog post on November 10th that the lame duck session "is a perfect opportunity to end the broken cycle of temporary patches" to the SGR problem.  "If Congress does not seize the moment to act now during the lame duck session all of the hard bipartisan, bicameral work that went into building that framework will be for naught, and the process of negotiating a solution will start all over again," said Wah.  The good news is that SGR repeal has gained some recent traction, showing that there is interest in Congress working together on this issue.  For example, the Republican Doctors Caucus on November 3rd sent a letter to Republican leaders urging them to pass the SGR REpeal and Medicare Provider Payment Modernization Act.  Also, more than 110 lawmakers signed on to a separate letter led by Reps. Kurt Schrader, D-OR, and Reid Ribble, R-WI, asking them to move forward with an SGR repeal.  You can find more information about the SGR issue, including the specific impact on Maine, here.

[return to top]

10 Medicare Payment Policy Revisions You Need to Know

Chances are you haven't been able to read through the nearly 1,200 pages that constitute the 2015 Medicare Physician Fee Schedule final rule released Oct. 31 and published recently in the Federal Register.  The AMA has pulled out the 10 top payment policy changes discussed in this mammoth document that you need to know about.

Among the policy changes discussed in the top 10 list are:

  • The sustainable growth rate formula calls for a 21.2 percent cut to physician payments, effective April 1.
  • Continuing medical education will not be reported under the Physician Payments Sunshine Act.
  • Proposed penalties under the value-based payment modifier will be scaled back.
  • The timeline for submitting new codes and revaluations of services will shift.

Read the full list and get additional details about each policy change at AMA Wire®.

  [return to top]

Final Notice on MMA Legislative Committee Meeting Tuesday Night, Nov. 18

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]

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.

12/8/14

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.

11/24/14

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.

11/24/14

Chief Dermatologist Job in Central Maine

Challenging, Lucrative, Chief Dermatologist job in central Maine - honoring and serving Veterans.  An experienced Dermatologist is needed in Augusta, Maine.  Must have an unrestricted medical license (from any U.S. state), and current BLS 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 Dermatology by the appropriate accrediting agencies.

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.

Contact John Poulin at 207-621-6913 or john.poulin@va.gov.

12/1/14

Physician Sought

DFD Russell Medical Centers (DFDRMC) operates three community health centers in beautiful Central Maine. We are seeking a full time physician for immediate placement.  A current unencumbered Maine license and proficiency with electronic medical records are required.

Our three health centers serve a multicultural, rural population of about 10,000 patients and have a family practice focus serving pediatrics to geriatrics.  We have integrated behavioral health, care managers, a patient assistance coordinator and an excellent clinical support staff to support the candidate in delivering excellent clinical care.

Excellent benefits, including medical, dental, life insurance, 401K retirement plan, flexible spending accounts, generous paid time off and an incentive plan.  Salary is commensurate with experience.

We are an equal opportunity employer committed to diversity in the workplace.  If you want additional information about this position, which combines making a difference in patients’ lives with a family-friendly work life, please fax or e-mail your resume as soon as possible to Laurie Kane-Lewis, CEO.

Fax: 207-524-2459 and Email: Laurie.kane-lewis@dfdrussell.org 

12/1/14

Department of Psychiatry Faculty Position

The Geisel School of Medicine at Dartmouth, Department of Psychiatry, in a productive collaboration with the State of Maine, is seeking psychiatrists to join our faculty for inpatient responsibilities at the Riverview Psychiatric Center.

Riverview Psychiatric Center is a 92-bed acute psychiatric facility located in Augusta, ME and is the flagship inpatient treatment center for Maine’s public mental health system.  Psychiatrists with expertise in general inpatient psychiatry or forensic psychiatry are encouraged to apply.

Academic duties can include teaching and supervision of medical students and residents. Research opportunities available and encouraged.

Candidates should be board certified or eligible in Psychiatry. This position will include a faculty appointment at The Geisel School of Medicine at Dartmouth at a rank and salary commensurate with experience. Curriculum vitae and three letters of reference, addressed to Dr. William Torrey, Search Chair, should be e-mailed to psychiatry.jobs@dartmouth.edu.  Please reference search number PS0314D.

Dartmouth College/Dartmouth Hitchcock Clinic/Geisel School of Medicine is an equal opportunity/ affirmative action employer with a strong commitment to diversity. In that spirit, we are particularly interested in receiving applications from a broad spectrum of people, including women, persons of color, persons with disabilities, veterans or any other legally protected group.

2/9/15

 

 

 

 

 

 

 

   [return to top]

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