December 8, 2014

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Free Workshop for Physicians Interested in Costs of Care, 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.  There is no cost to attend the evening workshop.

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.



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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Celebrate National Influenza Vaccination Week, Dec. 7-13

This week is National Influenza Vaccination Week.  We can't make the case any better than Dr. Jane Ho did in a terrific op ed piece in the Portland Press Herald last week.  Here is a link to the op ed.

The CDC recommends that everyone over 6 months of age should be vaccinated each year.

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Health Spending Growth Slowing to the Lowest Rate Ever Recorded

Independent analysts at the federal Department of Health and Human Services say that health spending in the U.S. grew in 2013 at the slowest rate ever recorded.  This slow down in spending first began after the last recession.   Total increase in spending in 2013 increased just 3.6% to $2.9 trillion, down from 4.1% in 2012.  Back in 2010, increases were nearly 10 % each year.  The report was published in Health Affairs.

The report speculates on the causes of the slow down and the following factors seem to be the most likely causes:

  1. Slow economic growth.
  2. Popularity of high deductible insurance plans
  3. ACA provisions requiring health plans to limit administrative expenses
  4. ACA provisions requiring approval of health plan increases in premiums over a certain level.




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Update on ACA Exchange Enrollment

DHHS announced this past week that 303,010 people selected health plans in a state or federal exchange during the second week of open enrollment.  Of these individuals, 49% were new customers.  HHS also urged individuals to shop around on the exchanges following a report that found that more than 7 in 10 individuals in the exchange could get similar coverage elsewhere for less money.  

 In other health reform news, new data from the Urban Institute Health Reform Monitoring Survey found that the uninsured rate dropped to 12..5% from 17.5% since the federal and state exchanges opened last year.

MMA is still looking for additional practices to partner with in reaching out to patients who may be eligible to shop in the exchange.  If you are interested, contact Gordon Smith at  The open enrollment period ends on Feb. 15, 2015.


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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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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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New Medicare Pay Cuts Coming in 2015; Participation Selections Due Dec. 31

Physicians have until Dec. 31 to decide whether they will be participating or nonparticipating physicians in the Medicare program next year.  In addition to the annual threat of a steep payment cut as a result of the sustainable growth rate (SGR) formula, another factor for physicians to consider in making the decision this time around is that 2015 will be the first year that the Centers for Medicare & Medicaid Services (CMS) will impose penalties under the value-based modifier (VBM) program. 

According to CMS, 1,010 groups of 100 or more eligible professionals will see payment adjustments from the VBM in 2015.  More than 300 of these groups will face Medicare payment cuts of 1 percent, while a few others will see cuts of 0.5 percent. Only 16 groups will receive bonuses of an amount yet unknown.

Other penalties that will be applied in 2015 based on 2013 performance—including those tied to quality reporting, meaningful use and ePrescribing—will decrease the limiting charge amounts that nonparticipating physicians can bill to patients for unassigned claims.  The VBM penalties and bonuses, however, will not apply to unassigned claims. That means practices facing a VBM penalty next year could avoid the penalty by choosing the nonparticipating physician status option.

As described in the AMA guide to Medicare participation options, the Medicare payment schedule for nonparticipating physicians is set 5 percent below the participating physician payment schedule.  At the same time, nonparticipating physicians can bill patients for 15 percent above that lower payment schedule amount. 

While participating physicians agree to accept assignment for all Medicare claims, nonparticipating physicians can decide whether to accept assignment on a claim-by-claim basis. This year, 96.6 percent of physicians are participating.  Physicians who want to become nonparticipating in 2015 must send a letter to their Medicare contractor postmarked before Jan. 1 to terminate their participation agreement for the coming year.

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Reminder: Physicians Must Review 2013 Sunshine Act Data by Dec. 31

It's not too late for physicians to initiate disputes of their 2013 data under the Physician Payments Sunshine Act (also known as the "Open Payments" program).  Even though the Centers for Medicare & Medicaid Services (CMS) publicly released most of the 2013 data Sept. 30, corrections can be made for the next data release. Physicians have until Dec. 31 to file disputes regarding their 2013 data. 

Visit the CMS website to access an Open Payments "search by name" tool.  This tool lets individual physicians see whether they received any reportable payments in 2013 prior to going through the cumbersome Open Payments registration process.

View instructions for registering in the Open Payments system on the AMA's Sunshine Act Web page.
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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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