HHS Announces Possibility of Extending Open Enrollment for Individuals Impacted by Penalty

HHS Secretary Sylvia Mathews Burwell stated this past week that the Obama Administration is considering re-opening the enrollment period for the individuals who learn at tax time that they will be assessed the penalty for not purchasing health insurance under the Affordable Care Act.

The penalty this year is 1% of income or $95, whichever is greater.  Next year, the penalty increases to 2%.  The Treasury Department has estimated that as many as 6 million people may owe the tax penalty for not purchasing health insurance in 2014.  

Update on Medicare Sustainable Growth Rate (Doc-fix)

Congressional leaders last week returned to fixing the Medicare Sustainable Growth Rate (SGR) formula but did not settle on a solution.  Physicians face a greater than 21% payment reduction April 1st if lawmakers cannot agree on a replacement and permanent repeal or another "patch."  

LePage Administration Asks U.S. Supreme Court to Review Court Decision on 19 and 20 Year Olds

The LePage Administration last Thursday, February 13th asked the U.S. Supreme Court to review the decision of the 1st Circuit Court of Appeals which ruled in November that the federal HHS was compliant with federal law in rejecting the Governor's plan to eliminate MaineCare coverage for 19 and 20-year old Mainers.  Commissioner Mary Mayhew said the case is ultimately about the right of the state to continue its effort to prioritize its welfare programs for the most vulnerable.

MMA Legislative Committee Weekly Conference Call, Tuesday, February 17th at 8 p.m.

The next MMA Legislative Committee weekly conference call for the First Regular Session of the 127th Maine Legislature will take place tomorrow, Tuesday, February 17th at 8:00 p.m.

Legislative Committee members and specialty society legislative liaisons are strongly encouraged to participate.  Any physician, practice manager, or other staff member who is interested in the MMA's legislative advocacy also is welcome to participate.  It is not necessary to RSVP for the calls.

Please use the following conference call number and passcode.  These will remain the same for every weekly call during the session.

Conference call number:  1-619-326-2772

Passcode:  729-7185

The purpose of the weekly conference calls is to review and finalize the MMA's position on bills printed the previous week, to hear the views of specialty societies on the new bills or their concerns about any current health policy issues, and to discuss the highlights of legislative action of the week.  The calls rarely last longer than an hour.  The MMA staff lists a suggested position for each bill and any medical specialty particularly affected by the bill.  

If you have an opinion about any of these bills, but cannot participate in the call, please contact Andrew MacLean, Deputy EVP & General Counsel at amaclean@mainemed.com or 622-3374, ext. 214.

The following are bills of interest to the physician community printed last week.  We will discuss the priority bills marked with an asterisk (*) first.  This will be important when the list grows in the next few weeks.

LD 301,  An Act To Improve Insurance Coverage for First Responders Answering a Call to Duty (monitor; emergency physicians)

LD 302,  An Act To Encourage Responsible Consumer Fireworks Use (monitor or support; emergency physicians, ophthalmologists)

LD 318,  An Act To Appropriate Funds to Kennebec Valley Community College for its Programs in Allied Health (monitor or support)

LD 319,  An Act To Strengthen the Economic Stability of Qualified Maine Citizens by Expanding Coverage of Reproductive Health Care and Family Services (support; pediatricians, OB/GYNs)*

LD 324,  An Act To Control Fireworks in Monhegan Island Plantation (monitor; emergency physicians, ophthalmologists)

LD 327,  An Act To Require Prescribers of Controlled Substances To Use the Controlled Substances Prescription Monitoring Program Software (oppose)*

LD 328, An Act To Allow Personal Representatives of Children Access to Certain Documents of the Department of Health and Human Services Regarding Child Protective Activities (monitor; pediatricians)

LD 339,  An Act To Clarify That the Telephone Number 9-1-1 Is the Primary Number Advertised or Promoted for Emergency Response Services (monitor; emergency physicians)

LD 343,  An Act To Align the Federal Affordable Care Act's Health Care Coverage Opportunities and Hospital Charity Care (monitor)*

LD 347, An Act Concerning Billing between Emergency Medical Services Providers and Insurance Companies (monitor; emergency physicians)*

LD 350,  An Act To Expedite MaineCare Payments for School Administrative Units (monitor; pediatricians)

LD 356,  An Act To Permit the New England School of Dental Technology To Grant the Degree of Bachelor of Science (monitor)

LD 358,  An Act To Provide Additional Oversight over the Management of the Department of Health and Human Services (monitor; Public Health Committee, psychiatrists)*

LD 359,  An Act To Assist Persons with Breast Cancer (support; OB/GYNs)*

LD 361,  An Act To Allow Licensed Dental Professionals To Own Dental Practices (monitor)

LD 362,  An Act To Require Dentists To Disclose the Cost and Origin of Off-site Laboratory Services (monitor)

LD 376,  An Act To Provide a Source of Funding for Drug Abuse Resistance Education (monitor; Public Health Committee, pediatricians)

LD 384, Resolve, To Study the Design and Implementation of Options for a Universal Health Care Plan in the State That Is in Compliance with the Federal Patient Protection and Affordable Care Act (support)*

LD 389, An Act Relating to the Sale of Hypodermic Apparatuses (monitor; Public Health Committee)

LD 397, An Act Regarding the Packaging and Labeling of Disposable Cleaning and Personal Hygiene Products (monitor or support; Public Health Committee)

LD 415,  An Act To Promote the Safe Use and Sale of Firearms (monitor or support; Public Health Committee)

LD 421,  An Act To Improve Program Integrity Activities within the Department of Health and Human Services (monitor)

LD 422, An Act To Improve Access to Treatments for Lyme Disease (oppose)*

LD 423, An Act To Require Child-resistant Packaging for Products Containing Liquid Nicotine (support; pediatricians)*

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ICD-10 Not Likely to be Delayed; MMA Announces Training Sessions May 8th and 9th

At a Congressional hearing last week, it was once again emphasized by CMS that no future delays are contemplated for the effective date of implementation of ICD-10.  It has already been delayed for two years at the request of the AMA and other physician organizations.  At this point, the October 1, 2015 implementation date is supported strongly by the health plans and CMS and Congress is unlikely to delay further the implementation date.

Year Two of Open Payment Disclosure Law About to Launch

The Centers for Medicare & Medicaid Services (CMS) announced last week that physicians, teaching hospitals, applicable manufacturers, and group purchasing organizations can now register or re-certify their Open Payments registration.  Drug and device companies can begin submitting data for any 2014 payments or transfers of value.  If necessary, they can also correct 2013 data. Physicians' and teaching hospitals' review and dispute period is anticipated to start in April.  Drug and device manufacturers must submit all payment data by March 31, 2015.

POLITICAL PULSE: Public Hearings on Minors Tanning and DHHS Supplemental Budget Bills

PHYSICIAN ORGANIZATIONS, AMERICAN CANCER SOCIETY, CANCER ACTION NETWORK, AND FAMILY MEMBERS TESTIFY IN FAVOR OF BILL PROHIBITING MINORS' USE OF TANNING FACILITIES BEFORE HHS COMMITTEE

Last Wednesday morning, February 11th, the Health & Human Services Committee held a public hearing on L.D. 123, An Act to Reduce Youth Cancer Risk.  Sponsored by Senator Geoffrey Gratwick, M.D., the bill would prohibit a minor from using a tanning facility in Maine.  The proponents' testimony was very compelling while the opponents' was specious.  Speaking in favor of the bill were:

• Senator Geoffrey Gratwick, M.D., prime sponsor of the bill
• Representative Michael "Mick" Devin
  
• Janice Pelletier, M.D. on behalf of the Maine Chapter of the American Academy of Pediatrics
• Brad Waddell, M.D. on behalf of clinical oncologists
• Christine Gervais and Betty Bricker-Small on behalf of oncology nurses
• Tina Pettengill on behalf of the Maine Public Health Association
  
• Peter Bouman, M.D. on behalf of the dermatology community
• Peter Michaud, J.D., R.N. on behalf of MMA
• Hilary Schneider, on behalf of the American Cancer Society, Cancer Action Network
• Angela Westhoff on behalf of the Maine Osteopathic Association
• Chuck Martin, a teacher
  

More than a half dozen other individuals representing patients, family members, and clinicians submitted written testimony or comment.  The opponents were represented by the General Manager of several local tanning salons.  You can find the testimony presented here.  We anticipate Democrats on the HHS Committee to support the bill and we hope to persuade some of the Republican members to join them.  We hear, though, that opposition to the bill is based not on any disagreement with science and medicine but on concern about the proper role of government.  Your contacts with Committee members will help, so if you would like to communicate with members about the bill, you will find the list of members here.  Senator Gratwick and proponents are trying to schedule a meeting with the Governor's Office to discuss the bill.  A similar bill passed the 126th Legislature but was vetoed by the Governor.  The MMA thanks Senator Gratwick for sponsoring the bill and all of the physicians for taking the time out of their busy schedules to come to the State House to testify in favor of the bill.

MMA SPEAKS IN FAVOR OF MAINECARE PRIMARY CARE FEE INCREASE AND HEALTH HOMES INITIATIVES IN DHHS SUPPLEMENTAL BUDGET BEFORE APPROPRIATIONS COMMITTEE

MMA EVP Gordon Smith testified in favor of the two provisions in L.D. 236, a FY 2015 supplemental budget for the Department of Health & Human Services, during a public hearing before the Appropriations and HHS Committees last Wednesday, February 11th.  The bill will ensure that the state budget remains in balance for the rest of the current fiscal year ending June 30th and includes approximately $1.9 M General Fund for the MaineCare Health Homes initiative and approximately $1.5 M General Fund for the ACA primary care fee enhancement for MaineCare.  You can find information about the Appropriations Committee here.  The HHS Committee held a work session on the bill last Thursday and included these two provisions in its recommendations to the Appropriations Committee.  The Appropriations Committee held a work session on the bill on Friday, but did not vote on it.

INSURANCE COMMITTEE RECEIVES REPORT OF MAINE HEALTH EXCHANGE ADVISORY COMMITTEE

Last Thursday afternoon, the Insurance & Financial Services Committee conducted a work session to accept the report of the Maine Health Exchange Advisory Committee.  The Chairs of the Committee, former legislators Margaret Craven (a Democratic Senator from Androscoggin County) and Sharon Treat (a Democratic House member from Hallowell), presented the report.  MMA EVP Gordon Smith served on the Committee.  You can find the final report here.

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Maine CDC announces 6 for ME Breastfeeding Learning Collaborative on March 27, 2015

The Maine CDC cordially invites you to the 6 For ME Breastfeeding Learning Collaborative on March 27th designed for physicians, advanced level providers, nurses and lactation professionals.  Participants will hear the latest research behind six of the ten internationally recognized best practices for improving breastfeeding. Opportunities will be available to explore strategies for adopting these six practices in your office practice or at the hospital.  There is no charge to attend and educational credits are pending.  Please share this widely, including on your websites and listserves.

Registration to Follow!

Contact Information: Christopher Pezzullo, DO, FAAP

Medical Director | Division of Population Health

Maine CDC | DHHS

Key Plaza, 4^th Floor, 11 SHS, Augusta, ME  04333-0011

phone: 207-287-5044

Fax: 207-287-4631

Email: christopher.pezzullo@maine.gov [return to top]

New England QIN-QIO Announces Diabetes and Cardiac Health Projects

• Everyone with Diabetes Counts (EDC) Project.  The project will improve the quality of life for your patients with diabetes and help them avoid complications.  Collaborate with key stakeholders in your community to identify and increase opportunities for Diabetes Self-Management Education (DSME) among under-served populations.
• Improving Cardiac Health and Reducing Disparities in Care Initiative.  The initiative will help improve the quality of care for your patients with cardiac disease and position your practice for financial incentive programs including Meaningful Use and value-based payment programs.

The New England Quality Improvement Network – Quality Improvement Organization (NE QIN-QIO), CMS’s new Quality Improvement Organization (QIO) for the state of Maine and the six New England States region, will be working with a small number of provider practices on Medicare’s latest quality improvement initiatives to improve the quality of care for your patients with cardiac disease and diabetes.

Goal: The primary objective with these initiatives is to reduce disparities in diabetes and cardiac care and improve the quality care by partnering with providers to promote health literacy, engage patients and families in diabetic self-management, improve targeted clinical outcome measures and optimize the use of electronic health records. 

Benefits to your practice:   At no cost, the NE QIN-QIO will support eligible practices by offering training and technical assistance with important QI initiatives such as Meaningful Use, PQRS, and Value-Based Modifier, Everyone With Diabetes Counts and Million Hearts ® Initiative.

Healthcentric Advisors, is a Rhode Island-based not-for profit company that was recently awarded the CMS contract to provide healthcare quality improvement services in Maine.  It is the prime contractor, in partnership with Qualidigm (the former QIO for Connecticut), and serves as the CMS Quality Innovation Network – Quality Improvement Organization (NE QIN-QIO) for all 6 New England States.  Healthcentric Advisors opened a state office in Brunswick, Maine, with a team of quality improvement staff, who will be accessible to work with providers in all settings of care throughout Maine. 

To discuss how your practice may take advantage of this opportunity and participate in one of these initiatives, call Doreen Bedaw, Program Coordinator, NE QIN-QIO, at 877-904-0057 x3105 or email her at: dbedaw@healthcentricadvisors.org.

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MMA Announces Changes to First Friday Educational Sessions; 25th Annual Practice Education Seminar to be Held Nov. 18 in So. Portland

Because of declining attendance, MMA has decided to cancel the First Friday presentations scheduled for October, November, and December 2015.  We apologize for any inconvenience this may pose.  Any person registered for one or more of the sessions will receive a refund or can use the amount paid as a credit toward other educational programs, including MMA's 25th Annual Practice Education Seminar.  The Seminar will be held this year on Wednesday, November 18th in So. Portland at the Doubletree Hotel.

Upcoming Events

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Dementia Care in Primary Care

Friday, March 13, 2015 

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 it also will be transmited to EMMC in Bangor.

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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Maine Concussion Management Initiative Training Programs – Level 1 and Level 2

General Information for 2015

When and where held:

              March 13, 2015 in Bangor at St. Joseph’s Hospital  

              May 1, 2015 in Machias at DownEast Community Hospital                       

              June 12, 2015 in Waterville at Colby College

              October 20, 2015 in Portland in conjunction with the Maine Brain Injury Conference

                             (Registration and fees will be through the Maine Brain Injury Conference for October 20)

Training Program: Training programs in 2015 will be updated.

              Level 1 - An Introduction to Concussions and Concussion Management

              Level 2 – Interpreting Neurocognitive Testing (Level 1 is a prerequisite for taking Level 2)

              8:00am – 8:15   Registration and Continental Breakfast (Level 1 and Level 2 are run simultaneously)

              8:15am-12:00pm            Level 1 – An Introduction to Concussions and Concussion Management

                                                          ○            The Diagnostic and Return to Play Dilemma

                                                          ○            Sport Related Concussion: Short and Long Term Sequelae

                                                          ○            Concussion Sideline Assessment

                                                          ○            Concussion Risk Factors, Treatment and Return to Function

                                                          ○            Tools in Concussion Management

                                                          ○            Concussion Case Studies

                                                          ○            Review and Wrap-up

              8:15am-12:00pm            Level 2 – Interpreting Neurocognitive Testing             

                                                          ○            Using ImPACT Testing in Concussion Management

                                                          ○            Interpreting ImPACT Test Results

                                                          ○            Case Reviews

                                                          ○            Review and Wrap-up

              Registration Fee:

              $100 for Health Care Professionals (MD, DO, NP, PA, Neuropsychologist, ATC, RN, PT, OT, SLP)

              $40 for school personnel and all other attendees

                             (School nurses, coaches, school athletic directors, administrators, parents, etc.)

              $20 for students – currently enrolled in a college program

Registration Fee Includes:

              1. Handouts

              2. Continental Breakfast and mid-morning break

              3. CEU/CME credits for Health Care Professionals

Registration Confirmation will be sent by email and will include:

              1. Directions to training location.            

              2. Training agenda.

For more information contact:

              Jan Salis, PT, ATC

              MCMI - Membership Committee Chair

              jsalis@aol.com

              (207) 577-2018

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SAVE THE DATE:  Maine Academy of Family Physicians Spring Events

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

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

For more information check our website:  http://www.maineafp.org/cme/mafp-cme-meeting

Complete schedule and registration available after January 15th. [return to top]

Job Openings: Note Posting of State Epidemiologist Position

Gastroenterologist Job in Central Maine

Challenging, Lucrative, Gastroenterologist job in central Maine - honoring and serving Veterans.  An experienced Gastroenterologist is needed in Augusta.  Develop your skills of diagnosing, treating, and managing patients, while living in an all-season recreational getaway!

Must-haves: Fellowship-trained and B/C specializing in Gastroenterology, fellowship-trained in Transplant Hepatology, and fellowship-trained in Advanced Endoscopy; experience in Upper Endoscopy (including EGD, Barrett's Esophagus diagnosis and treatment, vatical bleeding, bleeding ulcers, dilation, stent placement for esophageal strictures, and treating food impactions); experience in  Colonoscopy (diagnostic and therapeutic), ERCP, EUS with FNA (for both solid and cystic lesions), Push enteroscopy, Deep small bowel enteroscopy, Capsule endoscopy, and Combined Interventional and Endoscopic interventions (Rendezvous procedures); experience in hepatology and liver diseases; lastly, an unrestricted medical license and current BLS certification.

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.

Salary will be commensurate experience, using VA’s market-based physician pay system. 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.  Relocation expenses are not authorized.  Equal Opportunity Employer.  Disabled persons and/or veterans are encouraged to apply.

2/9/15

Rockport, Maine - Internal Medicine - Primary Care

Located directly on the shore of the Atlantic Ocean, Pen Bay Medical Center seeks BC/BE IM physician to join one of its hospital-employed Primary Care groups.  We offer:

• Competitive salary with productivity bonus
• Four day work schedule
• Comprehensive benefits
• Generous Paid time off
• CME Allowance
• 1:7 outpatient only call
• Impressive sub-specialty support
• Relocation allowance
• Loan repayment program

Come work and live where others go to vacation!

Please forward CV and confidential inquiries to:

John Bragg, Director, Physician Recruitment

Pen Bay Medical Center, 6 Glen Cove Drive, Rockport, ME  04856

(207) 921-5894    jbragg@penbayhealthcare.org

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