March 16, 2015

 
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Physicians' Day at the 127th Legislature is a Great Success

Sponsored by the MMA, the Maine Osteopathic Association, and the Maine Association of Physician Assistants, Physicians' Day at the Legislature on Thursday, March 12th was a positive experience for physicians, residents, medical students, and staff alike.  More than 50 representatives of the organizations filled the State House with white coats and engaged legislators on a wide range of topics of interest to the medical community and Maine patients.  In addition to meeting with Governor Paul LePage for an hour, participants met with all legislative leaders and listened to the four physicians in the Legislature comment on their experiences in public service.

Governor LePage responded to several issues during a wide ranging discussion including infectious disease, immunizations, medical school debt, methadone, scope of practice, and the needs of primary care.  Holly Lusk, J.D., the Governor's Senior Health Policy Advisor also attended the meeting.

In four separate meetings with legislative leaders, attendees pressed legislators on the need to expand access to care and opposed the establishment of limits on the treatment options available to patients struggling with addictions.  

Four physician legislators, Senator Geoff Gratwick, M.D. and Representatives Linda Sanborn, M.D., Patricia Hymanson, M.D., and Heidi Brooks, M.D. talked with attendees about what attracted them to public service and what surprises they found when they arrived at the State House.

Sponsored by MMA, the Maine Osteopathic Association, and the Maine Association of Physician Assistants, Physicians' Day at the Legislature is held on a biannual basis in odd-numbered years.  This year, the following specialty societies participated, along with several individual physicians and the students from the University of New England College of Osteopathic Medicine.

  •  Maine Academy of Family Physicians 
  • Maine Society of Eye Physicians and Surgeons
  • Maine Society of Anesthesiologists
  • Maine Gastroenterology Society
  • Maine Association of Psychiatric Physicians
  • Maine Council of Child and Adolescent Psychiatry
  • Maine Association of Physician Assistants
  • Maine Chapter, American Academy of Pediatrics

In addition, tables were also staffed in the Hall of Flags by representatives of MMA, MOA, Quality Counts, the University of New England, Maine AllCare, the Maine Association for Infant Mental Health, MMA's MICIS (Academic Detailing), and the Medical Professional Health Program.

Photos of the event are posted in the photo gallery on the MMA website at www.mainemed.com.  The MMA thanks all who attended and made the event a success.

 

Timed to coincide with Physicians' Day, the House and Senate passed a Joint Resolution Commending the Efforts of the Parties to Advance Changes in Primary Care Payment to Promote Better Primary Care for All Maine.  A copy of the Resolution will be available on the MMA website.

 

A hearty thanks to all those who attended and to the MMA and MOA staff who put the successful event together.

Efforts to Patch or Repeal and Replace Medicare SGR Continue

With only two weeks left before the next cut hits, efforts to fix the flawed Sustainable Growth Rate (SGR) formula driving Medicare physician fees has accelerated in recent days.  Several positive comments have been made by leaders in both the House and Senate and while the cost of the fix has increased to $175 billion, several Congressional leaders are calling for only some of the "cost" to be covered by offsets.  Without a temporary patch (this would be the 18th patch) or permanent repeal, physician fees will be reduced by 21.1% on April 1st.

The Maine Medical Association also participates in the so-called GEM (Geographic Equity in Medicare) Coalition which will again try to ensure the 1.0 Work GPCI floor is extended as part of any SGR Patch or fix.  Without Congressional action, we will lose the 1.0 Work GPCI floor effective April 1st.  The 1.0 Work GPCI floor has been in place by Congressional action since 2004 to prevent cuts to GEM states' Medicare physician payments that are based on flawed data regarding measurement of the Work GPCI adjuster.  The purpose of the GPCIs is to adjust for the cost of delivering a service, i.e., local price differences in rent, wages, malpractice, and physician work.

The GEM Coalition is comprised of 25 state medical societies plus the American Society of General Surgeons.

The 2015 Work GPCI for Southern Maine (Cumberland and York counties) is 0.982 and for the rest of Maine it is 0.967.

 
 
 
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Overview of Recent MMA Board Meeting

The MMA Board of Directors, chaired by Charles Pattavina, M.D., held a regular meeting at the Frank O. Stred Building in Manchester last Wednesday, March 11th from 4-6 p.m.  The priority topics for the meeting included an update on the organization's Digital Marketing Plan and highlights of the MMA's legislative advocacy activities.  Peter Michaud, J.D., R.N. presented the update on the Digital Marketing Plan, including the transition of the hosting of the MMA web site and improving the web site content.  Mr. Michaud also noted that the MMA Facebook page is now live and that the staff plans to increase its use of Twitter to communicate State House action in real time.  Board members also discussed current legislative activity, particularly work on the DHHS supplemental budget (L.D. 236) and the Governor's FY 2016-2017 biennial budget proposal.  Finally, members reviewed member "Listening Sessions" in 2014 and approved staff recommended 2015 "Listening Sessions" in Augusta on April 29th and later in Rockland and York.  

MMA President Lisa Ryan, D.O. reported on her work with Mr. Smith at the AMA National Advocacy Conference recently held in Washington, D.C.  The MMA contingent was able to meet with each member of Maine's Congressional delegation, including newcomer, Bruce Poliquin.  Discussion topics included the SGR issue, burdens on primary care, including lack of face-to-face time with patients, ICD-10 compliance, ACA Medicaid expansion efforts in Maine, and continuation of the SCHIP program.  Dr. Ryan also reported on the work of the Annual Session Committee that continues to consider ways to make the Annual Session relevant to more members and a good networking opportunity for all.  The 2015 Annual Session will be at the Harborside Hotel & Marina in Bar Harbor. 
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Health Insurance Marketplace Tax Penalty Special Enrollment Period: March 15 through April 30, 2015

The Open Enrollment Period for 2015 Marketplace health coverage is over, but consumers may still be able to get covered and avoid a tax penalty next year. There is a new Special Enrollment Period (SEP) for consumers who find out they must pay a tax penalty because they did not have coverage in 2014.  You are eligible for this SEP if you:

  • are not currently enrolled in 2015 Marketplace coverage,
  • attest that when you filed your 2014 tax return you paid the fee for not having health coverage in 2014, and
  • attest that you first became aware of, or understood the implications of, the Shared Responsibility Payment after the end of open enrollment (February 15, 2015) in connection with preparing your 2014 taxes.

This SEP will begin on March 15th and end on April 30th. Consumers who qualify must complete the entire enrollment process (that is, including selecting a plan) by 11:59 pm E.S.T. on April 30th.

Other life events that may qualify you for a Special Enrollment Period include:

  • Getting married
  • Having a baby, adopting a child or placing a child for adoption or foster care
  • Losing other health coverage
  • Permanently moving outside your plan’s coverage area
  • Gaining citizenship or lawful presence in the U.S.
  • Gaining or continuing status as a member of an Indian tribe or an Alaska Native shareholder.
  • Leaving incarceration
  • For people already enrolled in Marketplace coverage: Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions

If you think you my qualify for a Special Enrollment Period, you can apply at healthcare.gov or by calling 1-800-318-2596. For free in-person help with your application go to www.enroll207.com to find an assister near you.  More information about Special Enrollment Periods is available at www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/

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Louis A. Hanson, D.O. Scholarship to Honor Respected Physician Leader

A scholarship established by the MMC PHO will honor the late Louis A. Hanson, D.O., one of southern Maine's most respected physician leaders.  Scholarship funds will be awarded to physicians who have been selected for leadership development courses through the Daniel Hanley Center for Health Leadership, an independent non-profit organization based in Portland.  The Louis A. Hanson, D.O. Scholarship is meant to carry on the leadership example and legacy of Dr. Hanson and to help develop future generations of medical leaders.

Click here to read more about Louis A. Hanson, the scholarship, and the first scholarship recipient.

For more information about the Hanley Center, visit www.hanleyleadership.org

For scholarship information, contact:

  • Hanley Center For Health Leadership: Kathy Vezina, Associate Executive Director
  • MMC PHO: Lindsay Keller, Communications Specialist
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New AMA, CDC Initiative Aims to “Prevent Diabetes STAT”

Leading voices in health care launch urgent effort to reduce the incidence of type 2 diabetes, one of nation’s most debilitating chronic diseases

With more than 86 million Americans living with prediabetes and nearly 90 percent of them unaware of it, the American Medical Association (AMA) and the Centers for Disease Control and Prevention (CDC) today announced that they have joined forces to take urgent action to Prevent Diabetes STAT and are urging others to join in this critical effort.

Prevent Diabetes STAT: Screen, Test, Act - Today™, is a multi-year initiative that expands on the robust work each organization has already begun to reach more Americans with prediabetes and stop the progression to type 2 diabetes, one of the nation’s most debilitating chronic diseases. Through this initiative, the AMA and CDC are sounding an alarm and shining a light on prediabetes as a critical and serious medical condition. 

“It’s time that the nation comes together to take immediate action to help prevent diabetes before it starts,” said AMA President Robert M. Wah, M.D. “Type 2 diabetes is one of our nation’s leading causes of suffering and death—with one out of three people at risk of developing the disease in their lifetime. To address and reverse this alarming national trend, America needs frontline physicians and other health care professionals as well as key stakeholders such as employers, insurers, and community organizations to mobilize and create stronger linkages between the care delivery system, our communities, and the patients we serve.”

“The time to act is now. We need a national, concerted effort to prevent additional cases of type 2 diabetes in our nation – and we need it now,” said Ann Albright, Ph.D., R.D., director of CDC’s Division of Diabetes Translation. “We have the scientific evidence and we’ve built the infrastructure to do something about it, but far too few people know they have prediabetes and that they can take action to prevent or delay developing type 2 diabetes.”

People with prediabetes have higher-than-normal blood glucose levels but not high enough yet to be considered type 2 diabetes. Research shows that 15 percent to 30 percent of overweight people with prediabetes will develop type 2 diabetes within five years unless they lose weight through healthy eating and increased physical activity.

As an immediate result of this partnership, the AMA and CDC have co-developed a toolkit to serve as a guide for physicians and other health care providers on the best methods to screen and refer high-risk patients to diabetes prevention programs in their communities. The toolkit along with additional information on how physicians and other key stakeholders can Prevent Diabetes STAT is available online. There is also an online screening tool for patients at www.preventdiabetesstat.org to help them determine their risk for type 2 diabetes.

“This initiative is also about empowering patients to take control of their health,” said Dr. Wah. “It starts with knowing your risk factors.”

Over the past two years, both the CDC and the AMA have been laying the groundwork for this national effort. In 2012, the CDC launched its National Diabetes Prevention Program (National DPP) based on research led by the National Institutes of Health, which showed that high-risk individuals who participated in lifestyle change programs, like those recognized by the CDC, saw a significant reduction in the incidence of type 2 diabetes. Today, there are more than 500 of these programs across the country, including online options.

The AMA launched its Improving Health Outcomes initiative in 2013 aimed at preventing both type 2 diabetes and heart disease. That work includes a partnership with the YMCA of the USA to increase the number of physicians who screen patients for prediabetes and refer them to diabetes prevention programs offered by local YMCAs that are part of the CDC’s recognition program. This joint effort included 11 physician practice pilot sites in four states, where care teams helped to inform the development of the AMA and CDC’s toolkit. In the coming months, the AMA will be identifying states in which to strengthen the linkages between the clinical care setting and communities to reduce the incidence of diabetes

“Our health care system simply cannot sustain the continued increases in the number of people developing diabetes.” said Dr. Albright. “Screening, testing and referring people at risk for type 2 diabetes to evidence-based lifestyle change programs are critical to preventing or delaying new cases of type 2 diabetes.”

“Long-term, we are confident that this important and necessary work will improve health outcomes and reduce the staggering burden associated with the public health epidemic of type 2 diabetes,” said Dr. Wah.

Follow our social movement to Prevent Diabetes STAT on Twitter at #PreventDiabetesSTAT.

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**Editor’s Note:  Below are related links for patients and health care providers

Patient Resources

Physician Practice Resources

Toolkit for health care providers

About the AMA
The American Medical Association is the premier national organization dedicated to empowering the nation’s physicians to continually provide safer, higher quality, and more efficient care to patients and communities. For more than 165 years the AMA has been unwavering in its commitment to using its unique position and knowledge to shape a healthier future for America.

About the CDC

CDC works 24/7 saving lives and protecting people from health threats to have a more secure nation. Whether these threats are chronic or acute, manmade or natural, human error or deliberate attack, global or domestic, CDC is the U.S. health protection agency. [return to top]

MMA Legislative Committee Weekly Conference Call, Tuesday, March 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, March 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 815, An Act To Establish a Unified-payor, Universal Health Care System (monitor, though anticipate testifying "neither for nor against," presenting 2001 resolution, White Paper, and 2 survey results showing development of physician opinion on the topic)*

LD 818,  An Act To Amend the Maine Emergency Medical Services Act of 1982 (monitor; emergency physicians)

LD 821,  An Act To Promote Equity in Business Opportunity for Tobacco Specialty Stores (monitor; Public Health Committee)*

LD 823, An Act To Upgrade the Concealed Handgun Permit Law (monitor or oppose; Public Health Committee)*

LD 827,  An Act To Amend the Fluoridation Laws To Provide for Customer Choice (monitor or oppose; Public Health Committee)*

LD 830,  An Act To Eliminate the Dual Licensing of Physician Assistants (support; MEAPA bill)*

LD 831,  Resolve, To Reduce MaineCare Spending through Targeted Prevention Services (monitor; geriatricians)

LD 832,  An Act To Improve Public Health in Maine (monitor; Public Health Committee)

LD 834, An Act To Clarify the Use of "M.D." To Represent Achievement of a Graduate Degree by an Individual Not Licensed To Practice Medicine in Maine (support; MMA bill)*

LD 842,  An Act To Establish Peer Center Reimbursement (monitor; psychiatrists)

LD 854, An Act To Increase Access to Health Security by Expanding Federally Funded Health Care for Maine People (support)

LD 860,  Resolve, Directing the Department of Health and Human Services To Adjust Reimbursement Rates for Dental Services under the MaineCare Program (monitor)

LD 863, An Act To Update Professional Liability Insurance Reporting to the Bureau of Insurance (monitor or support)*

LD 865,  An Act To Protect Vision Care Patients and Providers (support; ophthalmologists)*

LD 867,  An Act To Provide Tax Fairness and To Lower Medical Expenses for Patients under the Maine Medical Use of Marijuana Act (monitor)

LD 868,  An Act To Remove Limitations on Reciprocity for Concealed Handguns Permits (oppose; Public Health Committee)

LD 886, Resolve, Directing the Department of Health and Human Services To Increase Reimbursement Rates for Home-based and Community-based Services (monitor)

LD 905,  An Act To Study Allocations of the Fund for a Healthy Maine (monitor or support; Public Health Committee)*

LD 917,  Resolve, To Improve Access to Dental Care through a Pediatric Medical Benefit (monitor; pediatricians)*

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POLITICAL PULSE: DHHS Supplemental Budget Remains at Stalemate; Biennial Budget Work Sessions Continue

HHS COMMITTEE CONTINUES BIENNIAL BUDGET WORK SESSIONS THIS WEEK; APPROPRIATIONS COMMITTEE CONTINUES WORK ON DHHS SUPPLEMENTAL BUDGET BILL (L.D. 236)

Members of the HHS Committee begin a second week of work sessions on the DHHS portions of the Governor's FY 2016-2017 biennial budget proposal.  For several weeks now, Republicans and Democrats on the Appropriations Committee have been unable to reach consensus on the DHHS supplemental budget bill, L.D. 236.  The sticking point is the Governor's proposal to divert money in the Fund for a Healthy Maine designated for the Low-Cost Drugs for the Elderly Program to the Medical Care - Payments to Providers account. 

The biennial budget negotiations likely will occupy much of the rest of the session, some time in June. 

 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).

LABOR COMMITTEE VOTES OUT BILL ON EMPLOYEE REPRESENTATION IN WORKERS' COMPENSATION CASES

A very brief work session was held last Thursday, March 12th, in the Labor, Commerce, Research & Economic Development Committee on LD 81.  This bill would allow an employee to bring a friend, family member or fellow employee to any meeting with employer representatives, which includes any physician appointment.  The committee voted 7-2 (of the members present) that the bill Ought to Pass. This guarantees an Ought to Pass majority of at least 7 in the final vote, but as of this writing the total has not been reported by the committee.  One committee member stated it was “inconceivable” that such a right would be denied to anyone in the medical appointment context.

CRIMINAL JUSTICE COMMITTEE CONSIDERS SERIES OF BILLS ON FIREWORKS

Over the past week, the Criminal Justice and Public Safety Committee has held public hearings and work sessions on four bills addressing the use of fireworks.  Two of the bills, LD 149 and LD 177, seek to regulate the use of fireworks within a certain distance from livestock or poultry.  Despite many equine professionals testifying on the problems fireworks have caused on their farms and with their animals, the majority of the committee voted against passing the bills.  The members voting against the two bills felt that the ability of municipalities to implement local ordinances—many of which already have—to address the individual needs of their communities was sufficient to regulate use near livestock or poultry. 

The third bill, LD 302, was drafted to ban fireworks use whenever the Governor issues a proclamation banning out-of-doors fires and to add statutory language to clarify that despite being legal fireworks may be “loud and unreasonable noise” under Maine disorderly conduct law.  At the bill’s public hearing a Vietnam War veteran testified about his PTSD and the terrible affect the noise from fireworks has on him.  Phantom Fireworks also testified in favor of the bill and highlighted its safety campaign focused on respecting neighbors.  The majority of the committee voted to support an amended version of the bill that removes the second section of the bill that would add fireworks to Maine disorderly conduct law.  It also slightly changed the language of the first section of the bill to clarify that fireworks may be prohibited during a no out-of-doors fires proclamation rather than require them to be banned during a proclamation.

Finally,LD 459 would define the remnants from the discharge of consumer fireworks to the definition of “litter” under the Maine Litter Control Act.  To illustrate the environmental effect of fireworks, a Maine fishing guide testified to the significant impact the debris has on waterway appearance.  Another individual noted that a degree of contamination is detectable in lakes after the discharge of fireworks.  The majority of the committee voted to support this piece of legislation.

All four bills will move forward to full votes by the legislature.

 

 

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MMA Among 100 Organizations to Express ICD-10 Concerns to CMS and Provide Recommendations

With the October 1, 2015 implementation date less than seven months away, 100 state and national medical organizations, including the Maine Medical Association, expressed concerns about ICD-10 in a March 4th letter to the Centers for Medicare and Medicaid Services (CMS).  These concerns related to testing, quality measurement, risk mitigation, software upgrades, specificity of codes, and audit plans.  

The groups outlined several concerns and recommendations in the letter.  The recommendations strongly urged CMS to:

  • Release more detailed end-to-end testing results broken out by the type and size of providers who tested, number of claims tested by each submitter, percentage of claims successfully processed, and specific details about problems encountered.

  • Provide details on how it plans to ensure that the measure calculations for these programs are not adversely impacted by the transition to ICD-10.

  • Ensure crosswalks do not attribute increased costs to a physician's value-based modifier score when switching to ICD-10. Any changes in measure specifications from ICD -9 to ICD-10 should demonstrate stability and be budget neutral during the transition.

  • Along with the Office of the National Coordinator for Health Information Technology, study the issue of software upgrades and make information about vendor readiness available to providers.

  • Confirm and broadly educate stakeholders and contractors that claims will not be audited simply for code specificity.

  • Instruct contractors that they are prohibited from engaging in audits that are only predicated on code specificity.

"By itself, the implementation of ICD-10 is a massive undertaking," concluded the organizations in the letter to CMS.  "The undersigned organizations remain gravely concerned that many aspects of this undertaking have not been fully assessed and that contingency plans may be inadequate if serious disruptions occur on or after Oct. 1.

Furthermore, physicians are being asked to assume this significant change at the same time they are being required to adopt new technology, re-engineer workflow, and reform the way they deliver care - all of which are challenging their ability to care for patients and make investments to improve quality.  We appreciate the opportunity to offer this perspective and these recommendations and look forward to further dialogue on this issue".

See other article in this Update regarding MMA educational and training sessions on transitioning your practice to ICD-10.  

 
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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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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: john.poulin@va.gov

3/16/15

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.

Requirements

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 @ jeremy.p.wilson@maine.gov. 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 www.maine.gov/dhhs/jobs 
Applications must be postmarked by March 31, 2015.

3/30/15

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 | Communications@HealthReach.org |www.SheepscotCHC.org.

3/16/15

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  afitts@kbhmaine.org

03/23/15

MaineRockport, Maine  – Hospitalist

Located on the shore of the Atlantic Ocean in Rockport, Maine, Pen Bay Medical Center is seeking a BC/BE physician to join our Hospitalist team. Enjoy a dynamic practice opportunity featuring:

  • 7 on/7 off scheduling
  • Paid time off
  • Broad subspecialty support
  • Competitive salary with incentives 
  • 148 shifts per year - Additional pay for additional shifts
  • Comprehensive benefits including medical, life & disability insurance
  • Relocation & CME reimbursement
  • Generous medical school loan repayment program

Join us, where the quality of the work and quality of your life are exceptional!

Send CV and confidential inquiries to John Bragg, Director, Physician Recruitment at jbragg@penbayhealthcare.org or call (207) 921-5894.

04/06/15

Assistant Medical Director Sought

The Assistant Medical Director is responsible assisting the Chief Medical Officer with all areas of medical and behavioral treatment policy, pharmacy, utilization review and management, disease / case management and quality management and for the medical oversight of daily case management and utilization management activities and decisions.

MD or DO with unrestricted medical license in Maine or New Hampshire required. Board certification in primary or specialty care. 

Minimum of five or more years of direct clinical experience in area of clinical practice, participation in a leadership role in medical staff organization activities, and management experience within a health care delivery system.  Minimum of three years’ experience in medical management in a managed care setting or the equivalent.

Apply online at www.JobsinME.com or email your information to blovejoy@maineoptions.org.

04/13/15

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 mlefay@kvhc.org or visit our website at www.kvhc.org.  KVHC is an equal opportunity employer.

06/01/15

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 JGrant@NEHS.net or (207)745-7059

3/30/15

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 psychiatry.jobs@dartmouth.edu.  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.

6/01/15

   
 

 

 

 

 

 

 

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Upcoming Events

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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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14th Annual Employment Law Update

Date and location:  March 17, 2015 at the Hilton Garden Inn, Freeport

Credits: 6.50, including 1.0 ethics

Online registration for live program

Brochure and registration form for live program.

Information and registration for live webcast

Sponsored by the MSBA Labor and Employment Law Section

Topics to include:

  • Understanding Reasonable Accommodation in the Workplace
  • Hot Topics: Ethical Pickles and Predicaments
  • Parenting and the Workplace: Employment Rights and Responsibilities from Conception to Adulthood
  • Settlement Agreements: Post-Settlement Disputes
  • New Developments You Need to Know
MMA members can register at the MSBA member rate.  Questions should be addressed to Linda Morin-Pasco at 207-622-7554 or lmorinpasco@mainebar.org .

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Coding Updates and ICD-10-CM Training Workshop

Boston, MA

March 20, 2015 for Staff

March 21, 2015 for Doctors

of Ophthalmology

March 20th Session for Staff

Morning Session

Hot reimbursement topics and what's new

New coding emphasis within EMR

Crucial coding concepts

  • How to use Corcoran's Office Visit Matrix

Afternoon Session

  • What is ICD-10?
  • How is it different?
  • How to find a code in ICD-10
  • Hands-on workshop with practical examples

March 21st Half Day Session for Doctors

A 4 hour "after hours" training course designed specifically for doctors. This will allow the doctor to have their full day work schedule and get the ICD-10 training they need. 

Morning Session

  • What is ICD-10?
  • How is it different?
  • How to find a code in ICD-10
  • Hands-on workshop with practical examples

Each Attendee Will Receive:

  • 2015 ICD-10-CM Comprehensive Manual ($99 value)
  • USB flash drive with critical reference files
  • General Equivalency Mapping (GEM)conversion

Register Here

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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:  http://www.maineafp.org/cme/mafp-cme-meeting

Complete schedule and registration available after January 15th.

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Please join us for the Northern Maine Interprofessional Collaborative Practice (IPCP) Summit

The University of New England (UNE) invites you to participate in the Interprofessional Collaborative Practice Summit, taking place on April 14, 2015 on the campus of Northern Maine Community College in Presque Isle.

Funded by UNE’s Maine AHEC Network (Area Health Education Center) and the Josiah Macy, Jr. Foundation, the Summit will host national and local experts to address the relationship between health professions education, clinical practice, and national healthcare reform.

During the course of the day healthcare providers will have an opportunity to learn more about:

  • Trends in and principles of interprofessional team-based practice 
  • Tools to implement interprofessional practice
  • How to develop interprofessional student clinical experiences that prepare the future workforce and help address healthcare shortages 

We encourage you to attend as individuals or as interprofessional teams!

THERE IS NO COST TO ATTEND THOUGH AN RSVP IS REQUIRED OF ALL ATTENDEES

Register online: https://www.surveymonkey.com/r/CYLZD32 and/or visit www.une.edu/ahec for more information

For assistance, please contact: Dawn Lovelace at 207-221-4561 or dlovelace1@une.edu or Dora Anne Mills at dmills2@une.edu or 207-221-4621

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