March 2, 2015

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MMA Lobbies Maine Congressional Delegation on SGR, Regulatory Relief and IPAB

MMA President Lisa Ryan, D.O. and staff were in Washington this past week to attend the AMA National Advocacy Conference and to ask Maine's Congressional Delegation to work with Congressional leaders to permanently repeal and replace the Medicare Sustainable Growth Rate formula which will reduce physician fees under Medicare by 21.5% on March 30th.

Dr. Ryan and MMA EVP Gordon Smith met with all four members of the delegation and Congressman Bruce Poliquin, Congresswoman Chellie Pingree, and Senators Susan Collins and Angus King all support a permanent repeal of the SGR formula and will be urging congressional leaders to act on a reform measure before the March 30th date.  Last year, key legislative leaders agreed on a five-year plan to replace the current formula but the measure stalled when the parties differed over how to pay for the legislation which the Congressional Budget Office had estimated at $140 billion.  In Maine, a cut of 21.5% would cost Maine physicians and hospitals more than $50 million between March 30th and the remainder of the calendar year.

While the Congress has had a year to work on a permanent fix, it is almost inevitable that by the end of the month Congress will enact another "patch" to the Medicare payment formula that will cancel the scheduled reduction in fees but will not permanently repeal and replace the formula.  If so, it will be the 18th temporary patch.  It is hoped that this next patch can lead to a permanent fix by the end of 2015.  The considerable cost associated with a permanent repeal continues to be a significant roadblock to success in our advocacy efforts, which will continue.

In additional to the Medicare payment issue, Dr. Ryan and Mr. Smith shared concerns with the delegation about the regulatory penalties about to hit physicians which detract from patient care and threaten the financial viability of practices.  Total impact of penalties associated with PQRS and HIT, along with the Sequester cut (2%) now total as much as 6.5% and could reach 13% or more by 2019.

Dr. Ryan and Mr. Smith also asked for support of S. 141, the "Protecting Seniors' Access to Medicare Act of 2015" which would repeal the Independent Payment Advisory Board (IPAB), a particularly controversial provision of the Affordable Care Act.  The IPAB is a 15-member board of unelected officials with little accountability that was established to extend Medicare solvency and reduce spending growth through the use of a spending target system and a fast-tracked legislative approval process.  While the IPAB cuts have not been required since enactment of the ACA, it is important to repeal the IPAB while the Congressional Budget Office score for doing so is low.  If the IPAB cuts were to be triggered, the cost for repealing could be significant.

During the conference, physicians heard from Sylvia Mathews Burwell, Secretary of HHS who directed her remarks primarily at the positive impact that the ACA has had on coverage resulting in a significant decrease in the percentage of Americans without health insurance.  But, the program was well balanced with Republicans Haley Barbour and Thomas Price (R, Georgia) delineating some of the failings of the law and speculating on the results of the upcoming Supreme Court decision in King v. Burwell.

The annual President's Lecture was given by noted surgeon and medical researcher Patrick Soon-Shiong, M.D., CEO and Chairman of NantWorks.  Dr. Soon-Shiong was recently featured on 60 Minutes and gave a dynamic talk on how patient data and genetic information are being combined in innovated ways to improve the care of cancer patients.



MMA Legislative Committee Weekly Conference Call, Tuesday, March 3rd 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, March 2nd 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 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 517, Resolve, To Reconcile Conflicts between the Home and Community-based Waiver Program for the Elderly and Adults with Disabilities and the Requirements of the Department of Health and Human Services and the Department of Public Safety (monitor)

LD 521, An Act To Amend the Health Care Practitioner Transparency Requirements (MMA bill; support)*

LD 524, An Act To Start a Pilot Program for Medical Substitution Treatment in a Local Community Setting (monitor or support; psychiatrists)*

LD 525,  Resolve, To Direct the Department of Health and Human Services To Report on Efforts To Reach in Rural Areas Persons Who Are Elderly, Disabled or Mentally Ill (monitor; psychiatrists)*

LD 526,  Resolve, To Require the Department of Health and Human Services To Request a Waiver To Prohibit the Use of Food Supplement Benefits for the Purchase of Taxable Food Items (monitor)

LD 528, An Act To Amend the Laws Regarding the Maine Organ and Tissue Donation Fund (monitor)

LD 534, An Act To Increase Crisis Intervention Training in the State (support; psychiatrists)

LD 535,  An Act To Amend the Laws Governing the Concealed Handguns Permit Application (monitor; Public Health Committee) (monitor; Public Health Committee)

LD 539,  An Act To Increase Utilization of the Dorothea Dix Psychiatric Center (monitor; psychiatrists)

LD 540, An Act To Improve Access to Dental Care through the Establishment of the Maine Board of Oral Health (monitor; Public Health Committee)

LD 547, An Act Regarding Service Dogs (monitor or oppose; ophthalmologists)*

LD 548, An Act To Provide a Concealed Handgun Permit for Active Military Members (monitor; Public Health Committee)

LD 552, An Act To Provide Funding for Home Visiting Services (monitor; pediatricians)

LD 556, An Act To Require Public Schools To Offer Instruction Related to Cardiopulmonary Resuscitation and the Use of an Automated External Defibrillator (monitor; Public Health Committee, pediatricians)*

LD 557, An Act To Provide Reasonable Accommodations for School Attendance for Children with Disabilities for Whom Medical Marijuana Has Been Recommended (monitor or oppose; pediatricians, Public Health Committee)*

LD 560, An Act Regarding Patient Information Under the Maine Medical Use of Marijuana Act (monitor; Public Health Committee)

LD 565, An Act To Authorize Municipalities To Impose Service Charges on Tax-exempt Property Owned by Certain Nonprofit Organizations (monitor)

LD 572, An Act To Ensure Appropriate Health Insurance Coverage for Prescription Eye Drops (MSEPS bill; support; ophthalmologists)*

LD 574, An Act To Amend the Laws Governing the Membership of the Maine Commission on Domestic and Sexual Abuse (monitor; Public Health Committee)

LD 576,  An Act To Adjust Appropriations and Allocations from the General Fund and Other Funds for the Expenditures of State Government Related to Position Changes for the Fiscal Years Ending June 30, 2015, June 30, 2016 and June 30, 2017 (monitor)

LD 582,  An Act To Establish a State Educational Medicaid Officer (monitor; pediatricians)

LD 584,  RESOLUTION, Proposing an Amendment to the Constitution of Maine To Prohibit the Denial of Equal Rights Based on the Sex of an Individual (monitor)

LD 587,  An Act Regarding Contract Indemnification (monitor)

LD 594,  An Act To Allow the Creation of a Local Option Sales Tax by Referendum (monitor)

LD 597,  Resolve, Regarding Legislative Review of Portions of Chapter 101: MaineCare Benefits Manual, Chapter III, Section 29: Allowances for Support Services for Adults with Intellectual Disabilities or Autistic Disorder, a Major Substantive Rule of the Department of Health and Human Services (monitor; psychiatrists)














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POLITICAL PULSE: Physicians and Patients Impacted by Proposed Biennial Budget; Key Hearings This Week

 Significant issues that will be the subject of hearings this week in addition to the primary care Medicare increase and the removal of methadone coverage from MaineCare

  • Cuts to the low cost elderly drug program;
  • Several cuts to hospitals including reductions in MaineCare reimbursement to Critical Access Hospitals, cuts to provider reimbursement and outpatient reimbursement.
  • Reduction in medication management payments under MaineCare in some settings.
  • Reductions in the Fund for a Healthy Maine.

The HHS portions of the budget will be the subject of public hearings before the Appropriations Committee the week of March 2nd.  MMA will be testifying on many of these issues but if you or someone from your practice would like to testify on any of these items, please let Andy MacLean at MMA know by calling 622-3374, ext. 214 or via e-mail to

See more on the biennial budget schedule and "Medical Care - Payments to Providers" account details below. 

Monday, 3/2, 1 pm:  Public Health, including the Fund for a Healthy Maine. 

Wednesday, 3/4, 10 am:  This is the "Medical Care - Payments to Providers" account and the primary opportunity to talk about reimbursement issues.  See more detail on the items before the Appropriations and HHS Committees on this day below.

Thursday, 3/5, 1 pm:  This is adult mental health and substance abuse, so is of particular interest to MAPP and the addiction treatment community, if the organizations want to comment on the MaineCare Benefits Manual, Section 65 cut and elimination of methadone treatment.

Friday, 3/6, 1 pm:  This is children’s services, including children’s mental health.

On Friday, January 9th, Governor LePage released his proposed biennial budget for SFY 2016-2017, the $6.3 billion budget for the two state fiscal years beginning July 1, 2015.  You can find the documents on the Governor's proposed biennial budget on the Bureau of the Budget web site.

The following are high points from the “Medical Care - Payments to Providers” or “MAP” account, the primary account dealing with physician & hospital reimbursement:

  • Provider-base reimbursement, p. A-336.  Total cut in each year is $7.3 M state & federal.  Description says, “Reduces funding by eliminating the separate facility fee payments that are billed on a UB-04 claim form and paid to hospitals for the services of hospital-compensated physicians, and provides funding to equalize reimbursement rates of hospital-compensated physicians and non-hospital-compensated physicians and eliminates the cost settlement component of hospital-compensated physician reimbursement.  This would eliminate the two separate fee schedules of reimbursement and ensure all physicians billing under Section 90 of the MaineCare Benefits Manual would be reimbursed on the non-facility fee schedule.” There is no separate language in Part C, the language section of the budget.
  • Health Homes, p. A-336. Replaces lost federal funding, so GF amount is $5.6 M/$7.8 M in the first & second years of biennium respectively.  Description says, “Provides funding for Health Homes for adults with serious and persistent mental illness and children with serious emotional disturbance (Stage B) and Health Homes for individuals with one or more chronic conditions (Stage A) due to the elimination of the enhanced federal match of 90/10 under the ACA.”
  • Primary care fee increase, p. A-336.  The amount is $7.4 M GF, $12.5 state & federal funds in each year of biennium.  Description says, “Provides funding for the reimbursement of primary care physicians at an enhanced rate which replaces expiring funds provided through the ACA.”
  • Community-based behavioral health services provided by hospital-affiliated entities, p. A-337.  Reduces funding by $1.3 M in each year of biennium.  Description says, “Reduces funding by requiring all community-based behavioral health services, including those that are operating as part of a hospital or in an administrative unit of a hospitality to bill and receive rates of reimbursement under Section 65 of the MaineCare Benefits Manual.”
  • Critical Access Hospital (CAH) reimbursement, p. A-337.  Saves $4.2 M in each year of biennium by reducing reimbursement from 109% to 101% of costs.
  • Methadone treatment coverage eliminated, p. A-339. Savings is $1.2 M/$1.5 M state & federal.
  • ER rates, p. A-339. Savings is $1.9 M/$2.6 M state & federal.  Description says, “Reduces by changing reimbursement on non-emergent use of emergency services to be paid at an office visit rate.”
  • Medicare Shared Savings Program cuts, p. A-339.  Savings is $29 M/$34 M state & federal.  Description says, “Reduces funding by reducing the Federal Poverty Level (FPL) in the Medicare Savings Program (MSP) to the federal minimum.”
  • Section 65 BH services 10% reimbursement cut, p. A-337. Savings in this line is $10.4 M in each year of biennium state & federal.  There's also at least one line on this cut in the BDS part of the DHHS budget.  FYI, despite the merger in the Baldacci years, the BOB still breaks the DHHS budget down into 2 parts, “DHHS, formerly BDS” (behavioral & developmental services) & “DHHS, formerly DHS” (human services).


Last week, the Insurance & Financial Services Committee held public hearings on three bills of interest to MMA.  On Tuesday, the MMA joined other public health advocates to support L.D. 135, An Act To Prohibit Tobacco Use Surcharges in Small Group and Individual Health Insurance Products.  Health insurance carrier interests opposed the bill.  On Thursday, the MMA supported a bill offered on behalf of the Maine Hospital Association that would require health insurance carriers to reimburse clinicians for services provided during the pendency of the credentialing process.  The bill is L.D. 124, An Act To Require Payment by a Carrier for Health Care Services Provided to Enrollees of the Carrier.  Again, the carriers opposed the bill.  Finally, on Thursday afternoon, the MMA commented "neither for nor against" L.D. 251, An Act To Limit Allowable Health Care Charges in Certain Specified Situations, a bill brought forward by Senator Geoffrey Gratwick, M.D. to protect patients from higher out-of-pocket costs when a patient sees an "out-of-network" clinician in an "in-network" hospital.  MMA and others expressed concern about the potential for unintended consequences in business negotiations among stakeholders in the health care system.  Jay Mullen, M.D., M.B.A., CEO of Bluewater Emergency Partners also participated in the hearing to express his concerns about the bill.  The work session on these bills will take place this Thursday, March 5th.


Last Wednesday afternoon, the Health & Human Services Committee held a work session on Senator Gratwick's bill, L.D. 123, An Act To Reduce Youth Cancer Risk.  Following brief discussion, the Committee voted 8-5 in favor of passing the bill.  All Committee Democrats supported the bill, as did several Republicans.  Opponents said that they understood the medical arguments, but objected to the government intruding in what should be private, family discussions.


Last Monday, MMA testified on behalf of its members and the state's plastic surgeons in particular, in opposition to Part H of the Governor's proposed FY 2016-2017 biennial budget.  As part of the Governor's effort to "modernize" Maine's tax code by broadening the sales tax base, Part H would extend the sales tax to "elective cosmetic medical procedures."  MMA made the point that it would be a "slippery slope" to go down the road of taxing any medical services, particularly when everyone is concerned about the cost of medical services today.  Connecticut is the only state in the country to impose such a tax.  Members who are concerned about this proposal should contact members of the Taxation Committee to express their opposition.


Last Friday, freshman Androscoggin Senator Eric Brakey (R) presented L.D. 112, An Act To Eliminate the Requirement That Adults Wear Seat Belts before the Transportation Committee.  Only one individual spoke in favor of the bill.  Many representatives of the medical community, Lifeflight, law enforcement, AAA Northern New England, and state and federal transportation officials opposed the bill.  The MMA thanks David Burke, M.D. and other representatives from Eastern Maine Health System for turning out to oppose the bill.  Those who are concerned about this bill are encouraged to contact members of the Transportation Committee.

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HHS Announces Extended Open Enrollment for Individuals Impacted by Tax Penalty

In an announcement that had been widely anticipated, CMS announced recently that there will be a special enrollment period from March 15th to April 30th for those individuals who learn during the tax preparation period that they will be paying a penalty for not purchasing insurance in 2014.  While they will still be penalized, they will be given the opportunity to purchase a plan in the exchange during this period so that they won't be subject to the higher penalty in 2016 (up to 2% of income or $325, whichever if higher).

When the previous open enrollment period closed on February 15th, Maine, once again, had higher than expected enrollment with nearly 75,000 individuals enrolling in the marketplace exchange.  Eighty-nine percent of these individuals are entitled to a subsidy lowering there monthly premium by an average of more than $300 a month. Last year, ninety percent of individuals received a subsidy.  MMA offers its congratulations and appreciation to the many navigators and certified assistors who worked incredibly hard during the enrollment period to get individuals insured.  We also want to acknowledge the continuing efforts of the Maine Health Access Foundation (MeHAF) in providing financial support for Enroll 207 and other initiatives aimed at outreach and education.

In another rule announced recently, CMS established the next open enrollment period.  It will run from November 1, 2015 through January 31, 2016.  This is a change from what was previously announced. [return to top]

AMA to FDA: New Proposal Would Stifle Innovation

A new proposal from the Food and Drug Administration (FDA) to impose a regulatory framework for laboratory-developed testing services and procedures would hinder medical innovation and result in reduced patient access to essential testing services and procedures, the AMA told the agency.

The FDA last year proposed a risk-based, phased-in approach to regulating laboratory-developed tests, which are services and procedures that represent the majority of advanced laboratory tests used in patient care. This is a critical part of the practice of medicine supporting physician diagnosis and prognosis and guiding treatment options for patients, the AMA said in comments to the FDA.  Laboratory-developed testing services and procedures are already performed under conditions regulated by an interlocking framework of federal laws, state laws and peer-review deemed authorities, which has allowed for accurate and reliable test design, development and performance to meet patient needs.

If the proposed FDA framework is finalized, physicians will not be able to offer or discuss alternative testing services, also known as off-label use, that often reflect more recent advancements in medical knowledge than commercial, pre-packaged test kits.  This could reduce physicians' ability to provide high-quality, personalized care. Further, the framework would increase administrative costs for physicians and clinical laboratories, potentially forcing them to limit the number of testing services and procedures they are able to offer.

Read more about the changes the AMA proposed to the FDA's framework. [return to top]

Prescription Drug Misuse Focus Turning Toward Treatment

 At least three-quarters of states are expected to introduce legislation this year related to prescription drug misuse, diversion, overdose and death – with an increased focus on treatment and prevention, signaling an issue that is at the forefront for both lawmakers and patients across the country.  Here are four facets of the issue that are being addressed in 2015.

The U.S. Centers for Disease Control and Prevention (CDC) reports that deaths involving prescription opioids remain unacceptably high, at more than 16,000 lives lost each year.  At the same time, there has been a substantial increase in deaths from heroin.  The CDC recently reported that 8,257 people died of heroin-related deaths in 2013—a 39 percent increase from 5,925 deaths in 2012.

These numbers point to the need for informed and focused state and federal efforts to save lives, including:

Increased access to naloxone.  Making the opioid overdose-reversal drug naloxone available to first responders and others is a 2015 legislative priority for at least 20 states. Naloxone helps save lives from overdose of opioids, whether a prescription opioid or heroin.

As an early adopter of efforts to expand access to naloxone, Colorado is now seeking to enhance its overdose prevention efforts with "Good Samaritan" provisions that allow others to aid an overdose victim without the fear of being arrested.  Colorado's bill would make naloxone available to a family member, friend or other person in a position to assist an individual at risk of experiencing an opioid-related overdose. Other states, including Nevada, North Dakota, South Carolina and Tennessee, also are working to enact legislation focused on saving lives from overdose.

In 2015, the AMA is working to get meaningful naloxone access and Good Samaritan legislation in all 50 states.

Expanding efforts across organizations.  As a founding member of the Alliance to Prevent the Abuse of Medicines, the AMA is working with other key industries across the supply chain to address critical issues related to the diversion of prescription drugs, from manufacturing and distribution to coverage and dispensing.  This alliance results in a unique and comprehensive perspective to address this epidemic.

Federal efforts to expand treatment. Taking on the prescription drug epidemic isn't just a problem for states. Federal legislation, such as the Recovery Enhancement for Addition Treatment Act (TREAT Act) could expand treatment for opioid addiction.  The TREAT Act would increase the number of patients that doctors can prescribe treatment for and would allow certain nurse practitioners and physician assistants to treat patients with substance use disorders by providing access to medication-assisted treatments such as buprenorphine.

Progress was made last year on the state and federal levels.  Michael Botticelli, director of the Office of National Drug Control Policy, addressed physicians at the AMA State Legislative Strategy Conference in January, stating that "science and data must guide our work to support all our efforts."  The White House also hosted a national summit last June to discuss federal, state and community responses to prescription drug misuse and deaths from overdose, underscoring the enormity and importance of the problem.

Prescription drug monitoring programs (PDMP). Legislation in Missouri would establish a PDMP, making it the last state to enact such a program.

In a letter to the Missouri Legislature, the AMA stressed the importance of long-term, stable funding for the state's PDMP to make sure the program can be maintained and modernized.

"In rare instances when PDMPs have been adequately maintained and funded, are available at the point-of-care with up-to-date information, and integrated into physician workflow, the efficacy of PDMPs is remarkable," the letter said.  "On the other hand, when PDMPs have not been adequately funded, states simply are left with outdated, inefficient databases that serve to frustrate the prescriber, dispenser and public health community."

"As the only state without a PDMP, Missouri has become a popular destination for doctor shoppers and pharmacy hoppers from all across the nation," said Missouri State Medical Association Executive Vice President Tom Holloway.  "This is not just a criminal justice issue—it's a very serious public health issue.  And it must be addressed.  A PDMP alone is not the cure-all, but it has the potential to be a powerful tool to help physicians and other health care providers identify prescription drug abuse and diversion problems when they come calling."

Besides Missouri, 30 states will likely see efforts to improve their PDMPs this year.

Learn more at the AMA's Web page on combating prescription drug abuse and diversion. [return to top]

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

At a Congressional hearing earlier this month, 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.

Following up on successful educational training sessions offered in 2014, the Maine Medical Association will again sponsor a two-day training session for coders and others involved in the transition to ICD-10 in a medical practice. Taught by experienced trainer Laurie Desjardins, CPC and offered through her firm, CDI Coding Strategies, the two-day course will be held at the MMA offices in Manchester on May 8th (Friday) and May 9th (Saturday).  Pricing will be similar to last year and the promotional materials for the course are being developed this week.  Watch your e-mail or next week's Update for further details.  This two-day training is to be distinguished from the Annual Coding Seminar April 3rd which is one of the regular First Friday education programs and is available both live in Manchester and via Webex.  The two-day training is only available on site.

For details on the two-day course, call Gail Begin at 207-485-1341.

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State Asks U.S. Supreme Court to Review Decision on Medicaid Coverage of 19 and 20-Year Olds

On February 12th, the State of Maine filed a petition for review with the U.S. Supreme Court of a decision by the U.S. Court of Appeals for the First Circuit's supporting the U.S. Department of Health & Human Services' rejection of the State's proposal to drop MaineCare coverage for 19 and 20-year olds.  This is a question of interpretation of the so-called maintenance-of-effort (MOE) provision of the Affordable Care Act (ACA).  The case is entitled, Mayhew v. Burwell, U.S., No. 14-992, petition for review filed 2/12/15.
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U.S. Supreme Court Hears Oral Argument on ACA Subsidy Case This Week

On Wednesday, March 4th, the U.S. Supreme Court is scheduled to hear oral arguments in the case known as King v. Burwell, that will determine whether individual subsidies through the ACA are available to those purchasing coverage through federal exchanges.  U.S. D.H.H.S. Secretary Sylvia Mathews Burwell told Congress last week that she is "confident" in the Administration's legal position and, therefore, is not developing a contingency plan in case the high court strikes down the subsidies. [return to top]

Federal Court in Maine Strikes Down Law on Certain Mail-Order Pharmacies

In a win for Maine-based pharmacies, Judge Nancy Torresen of the U.S. District Court for the District of Maine on February 23rd ruled that the Federal Food, Drug, and Cosmetic Act (FFDCA) preempts a state law enacted by the 126th Legislature that allowed residents to order prescription drugs from certain mail-order pharmacies in Australia, New Zealand, Great Britain, Northern Ireland, and Canada.  The litigation was filed in September 2013 by Maine retailers and pharmacies.  The case is Ouellette v. Mills, D. Me., No. 1:13-cv-00347-NT, 2/23/15. [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.

For more information contact John Poulin:


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


State Epidemiologist Sought

As State Epidemiologist in the Division of Infectious Disease, you will provide guidance and support to approximately 12-15 epidemiologists in the Infectious Disease Epidemiology Program for disease investigations and outbreak control, surveillance activities, and planned epidemiologic studies. Additionally, you will provide medical guidance, as needed, to all other programs within the Division; the Maine Immunization Program and the HIV, STD and Viral Hepatitis Program. You will be involved in formulation of statewide public health policy including providing legislative testimony by request for the Department. You will participate in the development of disease investigation protocols and the review of case investigations. You will consult with physicians and other health care professionals on disease prevention and control measures. You will respond to inquiries from the public and will coordinate response to media inquiries as directed by the Director of Maine CDC. You will interact with staff in the Division of Public Health System's, Public Health Emergency Preparedness Program, and the Health and Environmental Testing Laboratory, as well as the Division of Environmental Health's Health Inspections Program and other programs as requested. You will be part of the on-call rotation for nights and weekends (for telephone consultation, not on-site work) and provide technical support to other staff as needed when they are on call. As State Epidemiologist, you will supervise the medical epidemiology team which includes the Deputy State Epidemiologist and the Healthcare Associated Infections Coordinator. You will also provide medical guidance and oversight to the Tuberculosis Control Coordinator. You will serve as a liaison between federal CDC and Maine CDC on issues related to infectious disease. The State Epidemiologist will report to the Director, Division of Infectious Disease.


Graduation from an accredited school of medicine or osteopathy with board certification in an appropriate medical specialty. A twelve year combination of training and experience in medicine and public health, to include a minimum of four years experience as an epidemiologist, OR a Masters Degree in Public Health or a related field and six years experience in the field of medicine and public health, to include a minimum of four years of experience as an epidemiologist. 

SPECIAL REQUIREMENT: Applicants must be eligible for a license to practice medicine in the State of Maine and must have a valid license prior to the start of employment. 

APPLICATION INFORMATION:  For additional information about this position please contact Jeremy Wilson, Human Resources Assistant at (207) 287-1873 or by e-mail @ To apply, please forward a completed State of Maine application form and cover letter to: 

Department of Health and Human Services 
J. Wilson, Human Resources Asst. 
#11 State House Station 
Augusta, ME 04333-0011 

Direct hire applications are available at 
Applications must be postmarked by March 2, 2015.



Inland Hospital is a dynamic healthcare organization that believes in putting the patient first in every way. We are a 48-bed community hospital in Waterville; Lakewood, a 105-bed continuing care center on the hospital campus; 18 primary and specialty care physician offices in Waterville and five surrounding communities. Inland has been a proud member of EMHS since 1998. Inland patients have seamless access to a higher level of care when needed.

Come to Waterville, Maine - home of Colby College! This dynamic community offers quality schools, safe neighborhoods, and affordable real estate - plus plenty of shopping, dining and other activities.  Waterville is situated near many lakes and rivers, and is centrally located between excellent skiing and the seacoast, 15 minutes from Augusta (Maine’s capital), an hour from Bangor, and 75 minutes from Portland.

Enjoy living in a scenic area with four-season activities including hiking, skiing, camping, kayaking, sailing, hunting and fishing, golfing, snowmobiling, whitewater rafting, snowshoeing, and much more!

For Further Information, please contact:

Sherry Tardy, Director Business Development/Provider Recruitment, Inland Hospital by email or by phone at: 207-487-4085.


BC/BE Family Practice Physician Sought

Sheepscot Valley Health Center (Coopers Mills, near Augusta) seeks a BC/BE Family Practice Physician to provide primary care and preventive services in a practice that includes integrated behavioral health services. The selected candidate will join a team of physicians, nurse practitioners, and a physician assistant who offer medical care to community members from birth through retirement and beyond. Coopers Mills is ideally located between the state capital and the coast. The practice has been a vital part of the community since 1980 when a group of local residents recognized the need for high quality medical care closer to home. Over 4,000 people receive primary care and behavioral health services each year. We offer competitive compensation and malpractice coverage. The site is eligible for loan repayment. EOE. 

Contact: Recruiter, HRCHC, 10 Water Street, Suite 305, Waterville, ME 04901 | Phone: (207) 660-9913 | Fax: (207) 660-9901 | |


Augusta, Maine – Adult Psychiatrist

Kennebec Behavioral Health seeks a BC/BE adult psychiatrist with a Maine Medical License or immediate eligibility for licensure, for our Augusta location. Join our thriving, successful outpatient Medication Management Team and the chance to work for a multi-site health provider that has been serving our communities for more than 50 years. Located a short distance from the coast, ski resorts, golf courses, lakes, rivers and hiking trails, KBH operates central Maine’s largest Medication Clinic. Our Med Management team provides assessments, medication management and education.

Generous Sign-On Bonus!

KBH offers flexible, competitive compensation and benefits:

  • Health, dental, vision and life insurance
  • Relocation assistance
  • Travel reimbursement
  • 20 vacation days yearly
  • 11 holidays
  • 8 sick days
  • No on-call responsibilities or mandatory overtime.
  • Day time schedule (Monday – Friday)
  • Flexible schedule

Please forward CV and confidential inquiries to:

Amanda Fitts, Assistant Practice Manager

Kennebec Behavioral Health

67 Eustis Parkway

Waterville, ME 04901

(207) 873-2136


Family Medicine and Outpatient Internal Medicine Physicians

Katahdin Valley Health Center is recruiting dedicated Family Medicine and Outpatient Internal Medicine 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 and Brownville outpatient only practices.  KVHC is a fully electronic medical record site and offers a Four day work week with 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 and $2500 annually toward CME.  The call schedule is 1 in 9 with additional coverage from the Open Access Clinic.  Physicians who join KVHC are eligible to apply for NHSC Loan Repayment.  HPSA scores at the KVHC sites increased in 2015.

To learn more about KVHC and Practitioner Opportunities, please contact Michelle LeFay at or visit our website at  KVHC is an equal opportunity employer.


Lincoln, ME:  Family Medicine Opportunity with Leadership Option

  • Federally Qualified Community Health Center with 6 Locations
  • Medical Director opportunity if desired
  • Serves 19 small, rural towns in North Central Maine with over 14,000 active patients
  • Focused mission to serve/support underserved populations
  • Service area:  +/- 24,000
  • 4-day work week
  • Phone call 1:8
  • Excellent salary and benefit package, including FTCA malpractice insurance
  • Superb team of 25 multidisciplinary healthcare professionals, with collegial professional environment
  • On-site lab and radiology services
  • Work collaboratively with two local Critical Access Hospitals
  • National Health Service Corps, and/or other student loan repayment programs
  • J1 visa candidates welcome

Home of 13 Lakes. Thousands of miles of accessible recreational woodland and waterways appeal to those seeking nature, but this region is also within 45 minutes of Bangor, Maine’s third largest city, and UMaine’s flagship campus in Orono.

Contact:  Jamie Lynn Grant at or (207)745-7059


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, 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



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


              (207) 577-2018


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. [return to top]

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