December 1, 2014

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

The Maine Medical Association is pleased to bring Neel Shah, M.D., Executive Director of Costs of Care and an Assistant Professor at Harvard Medical School, back to Maine on the evening of Dec. 17th.  Dr. Shah recently wowed attendees at the Annual Meeting of the Maine Health Management Coalition with his real world examples of why physicians need to know the costs of treatment.

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.


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.


Register by Dec. 12th please by emailing  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.



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


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.


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.

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MMA Board of Directors Meets Wednesday, Dec. 3

The MMA Board of Directors will hold its final meeting of the year on this coming Wednesday, Dec. 3.  Priority issues on the agenda include:

  1. Process for Updating MMA's White Paper on Health System Reform (referred from Public Health Committee);
  2. Implementation of Prioritization Project (refers to effort by the Board to prioritize the many services and projects of the Association in an attempt to move the resources to those service most highly valued by the members);
  3. MMA's Legislative agenda for the upcoming 127th Maine Legislature.

Board members will also hear from President Lisa Ryan, D.O. regarding the agenda for the President's Retreat scheduled for Jan. 23-25 at the Samoset Resort in Rockport.  EVP Gordon Smith will update members on the work of the group meeting to make recommendations on the Digital Marketing Plan put together by flyte media.

All Board meetings are open to any MMA member, whether on the Board or not.  The meeting will be held from 4:00 pm to 6:00 pm at MMA offices in Manchester.

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Resident & Fellow Listening Session on Digital Communications, Dec. 9

Residents and fellows, join your peers for a casual dinner and conversation on how you use digital media in your professional life.

December 9, 6-8 pm

Bramhall Pub, 769 Congress, Portland

How do you like to stay connected and network?  Twitter?  Facebook?  How do you get your news and information?  What kind of content are you looking for from a professional society and how would you like to receive it?  In response to the rapidly changing world of digital media, the MMA is redesigning its approach to communications and wants to hear your input please.

RSVP to Gordon Smith, or Jennifer Reck,

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127th Maine Legislature Convenes Wednesday, Dec. 3

The 186 members of the 127th Maine Legislature will take their oath of office to officially assume their duties at the State House this Wednesday, December 3rd.  They are involved in a variety of orientation activities all this week.  On Wednesday, they will formally elect the Speaker of the House, the President of the Senate, and the Constitutional Officers, including the Attorney General, the Secretary of State, the Treasurer, and the Auditor.  They also will adopt their joint rules to govern themselves during the next two years.  Finally, the Presiding Officers likely will assign members to the various joint standing committees of the legislature and will set the "cloture" deadline by which legislators must have file requests filed.  The MMA anticipates that the cloture deadline will be Friday, December 19th and the MMA staff is working towards that deadline for the MMA's legislative agenda.  

 The legislature's web site has a new look that MMA members might find of interest:

Among the interesting items you will find on the legislature's web site is the Final Report of the Maine Health Exchange Advisory Committee on which MMA EVP Gordon Smith sits.

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Maine Medical Marijuana Program Goes Online: DLRS Offers Training this Month

The Division of Licensing and Regulatory Services (DLRS) within the Maine Department of Health and Human Services will launch a custom online service to allow licensed medical providers to certify patients for the use of medical marijuana on January 5, 2015.   The online service will only be available to licensed Maine medical physicians and nurse practitioners  in good standing and will produce a standard printed certification for all patients in the Maine Medical Use of Marijuana Program.  Its use is mandatory.

The new system includes several precautions that ensure information privacy and data integrity and conforms to standard health care information security standards and offers a variety of benefits to patients, physicians and the DLRS.  Enhanced security, direct relationship-building between the patient and provider and the immediate issuance of a patient designation card are just a few of the benefits.

Patient information is not captured or stored in this new system.  A basic transaction history will be retained for statistical purposes, which includes the date, name of the certifying medical provider, the zip code of the patient and whether the patient is over age 18.  Medical provider login information and passwords will be encrypted.

The DLRS has established a schedule for online training, which begins TOMORROW, Tuesday, December 2, from 7:30 to 8:30 a.m.  Other dates and times are: 

December 4, 3:30-4:30 p.m.

December 8, 3:30-4:30 p.m.

December 10, 7:30-8:30 p.m.

December 17, 9-10 a.m.

December 19, 3-4 pm. 

Providers can log onto the training at (access code:  6212632) at any of the above-mentioned times.  For more information, please contact Marietta D’Agostino, Maine Medical Use of Marijuana Program Manager, at 287-5810.

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Prepare Now for ICD-10 coming Oct. 1, 2015

As 2014 winds down, the Oct. 1, 2015 ICD-10 compliance date is drawing nearer.  CMS is making available to practices several resources to assist with compliance.  The CMS Road to 10 resource is particularly geared to small practices and offers free tools, information and training.  Whether your transition is underway, or you are just starting out, Road to 10 will help you navigate your path to ICD-10 compliance. 

  • Understand the basics of ICD-10, the differences between ICD-9/ICD-10 and more;
  • Explore common codes, primers for clinical documentation, clinical scenarios, and physician perspectives broken out by specialty. 
  • Create a customized action plan, personalized by specialty and practice details.

Visit the ICD-10 Medicare Fee-for-Service Provider Resources web page for Medicare Learning Network educational materials, including a complete list of MN Connects videos on ICD 10.

Visit the CMS ICD-10 website for the latest news and resources to help you prepare and sign up for CMS ICD-10 Industry E-mail Updates.

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MaineCare Seeks Provider Advisory Committee Members

MaineCare has restructured and empowered its Provider Advisory Committee.  This is a group of providers who meet quarterly with the MaineCare Medical Director, Kevin Flanigan, M.D., M.B.A. to review MaineCare changes/proposed changes and provide insight into the impact at the patient level.  This group also brings forward suggestions for future changes/improvements for MaineCare to consider.  The meetings are for two hours here in Augusta and can be attended by phone when necessary.  The commitment is for a three year term with the potential for a two additional three year terms. 

Presently there will be two members completing their terms this December.  The specific seats they occupy will need to be filled and the Program is hoping to maintain the same demographic make-up with their replacements.  The seats that need to be filled are assigned to a Surgeon and a Family Practice/General Practice physician.  In this case, both are male but their replacements do not need to be.  One is from a rural area and the other is from a central urban area and the Program would like to maintain those characteristics. 

Finally, members of this committee must be actively seeing MaineCare members and their practice must be open to accepting new members from MaineCare.

If you are interested in joining this Committee, please contact Gordon Smith, EVP at or 622-3374, ext. 212.

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Could New CBO Estimate Encourage Action on SGR Repeal 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.

The Congressional Budget Office has released an updated estimate of the cost to repeal the SGR that is now $5 billion lower than previously assessed.  The CBO estimates the cost now would be just under $119 billion, far less than the cost numbers floated in previous years.

Regardless of the cost, a growing number of members of Congress have expressed willingness to consider repeal without a full pay-for.  "It's really a bogus number to begin with," said Philip Roe, MD, (R-Tenn), co-chair of the Doctors Caucus.  "So the answer is yes, I'll vote for it with no offsets."   Two other Republicans, Rep. Joe Heck, MD (R-Nev) and Rep. Charles Boustany, Jr. (R-La) also expressed similar sentiments. 

MMA staff will be speaking with staffers for the Maine Congressional delegation this coming week to encourage action on the SGR repeal during the current lame duck session.


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CME Presentations on Prescribing for Pain and the PMP Now Available for 2015 through MMA

MMA has been notified by the state Office of Substance Abuse and Adult Mental Health Services that a $15,000 grant from federal funds has been approved for the purpose of educating Maine prescribers on the current clinical standards and regulatory requirements associated with prescribing for chronic pain and the appropriate use of the Prescription Monitoring Program.  The grant will fund at least ten programs over the next 16 months, beginning on December 1, 2014.  If your practice, medical staff, or specialty society would like to host such a session, please contact Gail Begin at MMA at  Because of the grant, there is no cost to host a session for the site or the attendees.

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SAVE THE DATE: Symposium on Dementia Care for Primary Care Clinicians Set for March 13th

Join us to learn about, and work with colleagues, on the implementation of best practices for Dementia Care in Primary Care.  This symposium will be offered on Friday, March 13.  The focus of this symposium is on implementation of a standardized approach to memory related problems in Primary Care.  The symposium will be useful to all providers working in Primary Care.  It will be an all-day event, offering CME as well as an opportunity to engage in an office based Quality Improvement process.

The symposium is sponsored by the Office of Aging and Disability Services and is free to participants.  We encourage bringing a member of your support staff who might be integral to implementation of process improvement.

 The primary site will be at MaineGeneral in Augusta, but work is in progress to transmit to both EMMC in Bangor and MMC in Portland.

Cliff Singer, MD                                                                           Roger Renfrew, MD, FACP

Geriatric Mental Health and Neuropsychiatry                     Facilitator Clinical Geriatrics

Acadia Hospital and EMMC                                                   MaineGeneral Medical Center

207-973-7026                                                                         207-621-3699

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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 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 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 or visit our website at  KVHC is an equal opportunity employer.


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


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: 


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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