December 15, 2014

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LAST DAY TO REGISTER: 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.



U.S. Senate Approves Dr. Vivek Murthy as Surgeon General; Approves Spending Measure

Late this afternoon, the U.S. Senate voted 51-43 to confirm President Obama's nomination of Dr. Vivek Murthy to be U.S. Surgeon General.  Dr. Murthy, 37, is the youngest appointee to this post and is the first of Indian-American heritage.  He has been controversial because he has been associated with "Doctors for America," a group of physicians favorable to the ACA and because of his willingness to speak out in favor of further gun control in this country.

 This work follows a contentious weekend of work for the Senate when they finally approved a $1.1 trillion spending measure to keep the government operating.  The vote was 56-40.  

Time is growing short for action on the Medicare SGR issue, though both chambers are scheduled to be in session tomorrow. [return to top]

Report on Healthcare Cost Workgroup Meeting of Dec. 8, 2014
The Healthcare Cost Workgroup staffed by the Maine Health Management Coalition (MHMC) met last Monday (Dec. 8) and worked on revising the implementation process for providers and payers interested in participating in voluntary growth caps which are now the focus of the Workgroup's attention.

The newest proposal requires that letters of commitment for voluntary growth caps be signed by all parties in ACO arrangements including providers, purchasers and payers, if the ACO is agreeing to the cap.
Hospitals had criticized the previous proposals which had not included the purchasers and payers in the commitment process.  The proposed letter now would read:
   "We understand that keeping annual growth at or below the voluntary cap will require contributions from all parties, including providers, employers, and payers; and we pledge to do our part to support this collective effort and help achieve the voluntary growth cap targets."
The implementation process still calls for the calculations of the growth cap to be determined by the MHMC in coordination with the Workgroup.  The Workgroup is expected to develop a mechanism for review to modify growth caps on either a prospective or retrospective basis to address the impact of significant unexpected events.

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America's Health Rankings Drops Maine to 20th Place, the Lowest in New England
America's Health Rankings is the longest running assessment of the nation's health on a state-by-state basis.  This year's rankings were recently released and Maine dropped to 20th compared to last year's rank of 16.  

Of particularly interest to physicians re Maine data:
  • Low prevalence of low birth rank was a strength in the report.
  • Low immunization coverage among children was a weakness in the report, along with limited availability of dentists.
  • In the past 2 years, smoking decreased by 11 percent from 22.8% to 20.2% of adults.  The prevalence of smoking in Maine has declined significantly in the past 20 years.
  • In the past 2 years, drug deaths decreased by 16 percent from 13.1 to 11 deaths per 100,000 population.
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Health Insurance Marketplace 101 Webinars
The Denver Regional Office of the Centers for Medicare & Medicaid Services is offering Health Insurance Marketplace 101 webinars every Tuesday afternoon at 3pm EST now through the end of Open Enrollment on February 15, 2015. Registration is not required.  Information about the webinar including dates, topics to be covered, and how to view the webinar is available here[return to top]

Maine Medical Marijuana Program Goes Online: DLRS Offers Two Additional Training Sessions this Week

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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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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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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Job Openings

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


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

Dementia Care in Primary Care

Friday, March 13, 2014

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



SAVE THE DATE:  Maine Academy of Family Physicians Spring Events

23rd Annual MAFP Family Medicine Update – April 8-10, 2015, at the Atlantic Oceanside in Bar Harbor

April 11th (tentative) Certified Medical Examiner Training (for DOT Exams) – dependent on registration minimum met

For more information check our website:

Complete schedule and registration available after January 15th.

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