Sharp Increase in Drug Overdose Deaths Leads to Summit August 26th

Governor LePage announced  that he will bring together law enforcement officials and drug treatment advocates at a summit on August 26th to address the state's drug abuse epidemic.  The announcement was made following a report of 14 heroin overdoses that recently occurred in Portland during a 24-hour period.  Today, the White House is expected to announce a new initiative involving public health and law enforcement officials in up to 15 states aimed at collecting more data on the supply and distribution of heroin.

Governor LePage also has recently sent a letter to Legislative leaders asking that they reconsider his request to increase funding for more MDEA agents.  The Legislature during the recently concluded session filled only four of the 14 additional MDEA agents the Governor requested in his proposed budget.  The attention focused on the recent increase in overdose deaths is certain to renew the debate on whether the answer to Maine's drug problem is more law enforcement to stop the flow of heroin and other illicit drugs into the state or more prevention and treatment resources.  

How Physicians are Leading the Fight Against Opioid Overdoses

Opioid overdose is a serious public health problem that has reached crisis levels across the United States, with 44 people dying each day from overdose of prescription opioids, and many more becoming addicted.  No community is untouched.

That’s why the AMA has convened a task force with the American Osteopathic Association, the American Dental Association, and more than 20 state and specialty medical associations to work collaboratively to address the opioid public health epidemic by identifying best practices and implementing them across the country.

“This epidemic is complex, and the remedy won’t be simple.  It will require a sustained, comprehensive approach,” said Patrice A. Harris, MD, chair-elect of the AMA Board of Trustees, in an AMA Viewpoints post.  “As a group, we have developed a strong roadmap that we hope will bring America’s physicians, other health care professionals and patients together as partners on the path to eliminating this public health epidemic.”

The task force’s initial focus is on steps physicians can take now to help their patient populations:

• Register for and use state-based prescription drug monitoring programs (PDMP).  Physicians should register for and consult these databases to identify patients at risk for opioid misuse and help patients with substance use disorders get appropriate treatment.
• Discuss with patients available treatment options.  When caring for patients with pain, physicians need to understand the best possible course for managing that pain with the tools available.
• Take advantage of educational opportunities.  Engaging in robust education activities that meet the needs of specialties, practices and patient populations is key to delivering appropriate care for each patient. The AMA encourages physicians to access resources that can enhance their education and promote comprehensive, appropriate pain treatment while safeguarding against opioid overdose. Resources also support treating patients with substance use disorders and expanding access to naloxone.

The AMA also is calling on states to make sure their PDMPs are truly valuable tools.   These databases need to protect patient privacy, contain relevant and reliable data, allow care teams to seamlessly integrate that data into their work flows, and enable data sharing across state lines.

Robert Rich, MD, chair of the American Academy of Family Physicians Commission on Health of the Public and Science and the academy's representative on the task force, stressed the importance of useful PDMPs.

“I practice in a state that has had a functioning PDMP for several years, and on more than one occasion, I have been surprised by the information contained in that PDMP,” Dr. Rich said in a news release. “[That includes] the patient who was obtaining opioid pain relievers from several providers in violation of my pain contract with that patient as well as the patient that I was convinced was obtaining opioids from several providers but who was compliant with the terms of their pain contract when the PDMP was accessed on serial visits.”

Addiction medicine specialist Richard Soper, MD, who represents the American Society of Addiction Medicine on the task force, echoed Dr. Rich’s comments.

“The help of every clinician in every treatment setting is needed to help bring an end to this public health epidemic,” Dr. Soper said in a news release.  “The sad truth is that every death related to opioid misuse could have been prevented with effective treatment.  In forming this task force, the AMA takes a leadership role in [preventing] the devastating consequences associated with the disease of addiction.”

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ICD-10 Update: Only Weeks to Go; CMS Call on August 27th to Help Prep

Fewer than 50 days remain before the October 1st deadline to adopt ICD-10.  Is your practice ready?  Do you know how to handle claims that span the implementation date?  If you are not sure of the answers to these questions, make sure to participate in a provider call with the Centers for Medicare & Medicaid Services (CMS) from 2:30 to 4 p.m. Eastern time August 27th.  Experts from the American Health Information Management Association (AHIMA) and the American Hospital Association (AHA) will offer coding guidance and tips, along with updates from CMS. The call also will cover:

• How to get answers to coding questions
• What to do with claims that span the implementation date
• Results from acknowledgement and end-to-end testing weeks
• Resources for physician practices

CMS has already expanded registration for this call once, so  register now to secure a spot.  Additional important resources that can help you get ready over the next seven weeks include:

• CMS is offering free assistance, including its "Road to 10" website aimed specifically at smaller physician practices.  This collection includes primers for clinical documentation, clinical scenarios and other specialty-specific resources to help with implementation.  Read more about the agency's resource offerings.
•  Six things you should know about the ICD-10 transition and the flexibilities the American Medical Association (AMA) secured for physicians.
• A special series at AMA Wire® examines what you need to do each month to prepare for the transition, whether you're an ICD-10 expert or just getting started.
• The AMA's ICD-10 Web page offers important information and resources  on implementation planning, from cross-walking between ICD-9 and ICD-10 to testing your readiness.

Choosing Wisely the Focus of MMA Senior Section Luncheon August 26
The MMA Senior Section quarterly luncheon will be held on Wednesday, August 26 from 11:30am to 1:30pm at the MMA offices in the Frank O. Stred Building in Manchester.  The presentation will be by Quality Counts Executive Director Lisa Letourneau, M.D., MPH who will bring Section members up to date on the very popular Choosing Wisely initiative.  The Choosing Wisely initiative is designed to better engage patients by educating them about questions they should be asking as they face a medical encounter, procedure or course of treatment.

Governor LePage and Attorney General Mills to Speak at MMA Annual Session

Governor Paul LePage and Attorney General Janet Mills have both confirmed their availability to speak at the MMA's 162nd Annual Session.  Governor LePage will speak at 10:00 am Saturday morning, September 12th and Attorney General Mills will speak at noon on the same day.  The Governor will speak for twenty minutes and will take fifteen minutes of Q & A following his remarks.  The Attorney General will speak for approximately a half hour and also is willing to take questions from attendees.  The Governor and Attorney General will not be speaking together, which is no surprise to any MMA member who keeps current with Maine's political scene.

Registration materials for the meeting in Bar Harbor, from September 11-13, 2015 has been mailed to each MMA member and will also be included in the next issue of Maine Medicine which will be arriving in offices around August 12th.  Registration is also available on the Association's website at www.mainemed.com.  The meeting once again will be held at the Harborside Hotel & Marina and opens with a reception on Friday evening, September 11th.  Three hours of category one CME has been applied for and the focus of the meeting will be "Advocating for the Profession."  Please make plans soon to join your professional colleagues to discuss issues of common interest and to conduct the annual business of your association.  Anyone wishing to submit a Resolution for consideration should send it to EVP Gordon Smith via e-mail to gsmith@mainemed.com no later than August 15th.

Senator King Convenes Roundtable on Telemedicine

Senator Angus King on Thursday convened a roundtable – which brought together health care experts, broadband providers, representatives from the University of Maine, University of New England, and Husson University, the Maine Medical Association, state representatives, and innovative telemedicine businesses – to discuss the benefits of telehealth technology, its implications for the future of Maine's workforce, and how its delivery can be improved across the state and country.

Senator King called for greater federal investment in telehealth technologies and regulatory changes that can help improve access to vital health care services for people, especially the elderly, in rural states like Maine. “Telemedicine has the potential to revolutionize the way we deliver health care in America.  Right here in Maine, we have seen how new telehealth technologies are helping to connect people to their doctors without even leaving their home,” Senator King said.  “Through collaboration and collective public-private efforts, we can harness the potential of telemedicine to make health care more accessible, lower costs, and improve care all at the same time.”

Among the topics covered in the discussions were the benefits of telehealth technology, its implications for the future of Maine's workforce, and how its delivery can be improved across the state and country.  Challenges to implementation include regulatory uncertainty, inconsistent reimbursement rules and rates, and patient protection and privacy issues. [return to top]

Some New Laws Affecting Medicine

Several of the bills that are now clearly part of Maine law under the Maine Supreme Judicial Court’s recent opinion in the “veto” case are of interest to the medical community.  They affect such matters as Medicaid, opioids, smoking, prison health care, and mental health care.

Physicians will be affected by some or all of the following:

• LD 582 (Public Law 359), An Act to Establish a State Educational Medicaid Officer;
• LD 319 (Public Law 356), An Act to Strengthen the Economic Stability of Qualified Maine Citizens by Expanding Coverage of Reproductive Health Care and Family Services;
• LD 140 (Public Law 351), An Act To Expand Access To Lifesaving Opioid Overdose Medication;
• LD 1246 (Public Law 346), An Act To Strengthen Laws Regarding the Manufacture and Sale of Methamphetamine and Other Drugs;
• LD 787 (Public Law 340), An Act To Provide Tax Credits for Adult Day Care and Respite and Hospice Care;
• LD 729 (Public Law 330), An Act To Add Acetylfentanyl and Methylfentanyl Derivatives to the List of Schedule W Drugs;
• LD 91 (Public Law 326), An Act To Allow Dental Hygienists To Prescribe Fluoride Dentifrice and Antibacterial Rinse;
• LD 1391 (Public Law 325), An Act Regarding the Treatment of Forensic Patients;
• LD 1108 (Public Law 318), An Act To Protect Children and the Public from Vapor from Electronic Smoking Devices;
• LD 1013 (Public Law 315), An Act To Prevent the Shackling of Pregnant Prisoners and Pregnant Juveniles; and
• LD 1145 (Public Law 309), An Act To Improve Maine's Involuntary Commitment Processes.

All of these laws will be examined more fully in the MMA’s upcoming review of the legislative session. [return to top]

Nearly An Additional Million Americans Enroll in Exchanges After Open Enrollment

Based on changes in work or life circumstances allowing for enrollment at any time, nearly a million people enrolled for health insurance under the Affordable Care Act after the February 15th enrollment deadline.   The Obama administration said this past Thursday that between February 23rd and June 30, 2015,  943,934 Americans enrolled for coverage.  The Administration also announced that the rate of uninsured has fallen by 15% since 2013. [return to top]

CME on Opioid Prescribing

SAMHSA is sponsoring a free CME course entitled “Clinical Challenges in Opioid Prescribing: Balancing Safety and Efficacy” on September 3rd, at the Double Tree in South Portland, from 7:30 a.m. to 5 p.m.  The course, designed for all clinicians practicing in primary care settings, will provide specific knowledge and skills associated with safe prescribing of opioids, including balancing optimal pain relief and preventing inappropriate use of opioid analgesics.

This program is provided by the Postgraduate Institute for Medicine and the Substance Abuse and Mental Health Services Administration (SAMHSA), in collaboration with the Maine Behavioral Health Workforce Development Collaborative.  It carries a maximum of 8.5 Category 1 CME credits.  Faculty include Ted Parran, Jr., MD, FACP,
Case Western Reserve University School of Medicine, Cleveland, Ohio, and Stephen Wyatt, DO,
Carolinas HealthCare System, Charlotte, NC

For more information, or to register for the program, click here.  The MMA is not a sponsor or otherwise involved with the program.

9 Key Health Care Issues States May Face in 2016

More than 100 national, state and specialty society lobbyists, general counsel, health policy experts, and key staff gathered recently to exchange information and strategies on critical state health care issues, and participate in an informal format that supports open dialogue and idea-sharing.

The 9 items that came up for discussion at the AMA State Advocacy Roundtable Conference included:

• 1.  Physician leadership in reversing the nation’s opioid epidemic
• 2.  The future of Medicaid managed care
• 3.  Strategies for protecting the patient-physician relationship
• 4.  Winning the hearts and minds of employed physicians
• 5.  Protecting physicians from anticompetitive health insurance and hospital market consolidation
• 6.  The next chapter in network adequacy and out-of-network care
• 7.  Protecting your medical board from antitrust liability
• 8.  Navigating a safe path to promoting modern medicine
• 9.  Emerging trends in scope-of-practice advocacy

Staff in the AMA Advocacy Resource Center moderated the sessions and discussed how AMA model legislation, national data and other key resources could be adapted for state- and specialty-specific needs.  MMA attorneys Gordon Smith, EVP and Peter MIchaud, Associate General Counsel participated in the roundtable meeting.

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Job Openings

Family Medicine and Outpatient Internal Medicine Physicians

Winthrop Family Medicine Family Practitioner

MaineGeneral Medical Center in Augusta, Maine is seeking a full-time, outpatient BC Family Practitioner to join our nationally recognized Advanced Medical Home practice that delivers care in a team model. Join a collaborative group made up of 11 MDs, DOs, NPs and PAs and practice in an “Open Access” model of scheduling. Provide a full range of care including: OB, newborn and pediatric care, adult medicine, gynecology, geriatric and nursing home care. Technology includes an electronic medical record, online digital radiology program, and online hospital records and ordering. MaineGeneral offers a comprehensive benefits package. The brand new, state-of-the-art, 192-bed MaineGeneral Medical Center at the Alfond Center for Health offers comprehensive inpatient and outpatient services for the surrounding communities. We’re located just an hour north of Portland, Maine’s largest city, and three hours from Boston. Contact Tiffiny Lamarre, Physician Recruiter at tiffiny.lamarre@mainegeneral.org.

9/7/15

Family Medicine Physician

Oakland Family Medicine, a hospital-employed outpatient Family Medicine practice located in Oakland, Maine, is recruiting for an experienced Family Medicine Physician to join our growing team. Responsible for providing care for pediatric through adult patients while working in collaboration with our practice administrator, providers and senior management team as Oakland continues the transition to Patient Centered Medical Home. Join our team of four family medicine physicians and one physician assistant and collaborate with a unique mix of seasoned physicians who have practiced in the area over 10 years, and new team members who have recently joined our group. Weekly schedule will be 32 hours of patient contact time and up to 8 hours of administrative time. MaineGeneral offers a comprehensive benefits package. We’re located just an hour north of Portland, Maine’s largest city, and three hours from Boston. Contact Tiffiny Lamarre, Physician Recruiter at tiffiny.lamarre@mainegeneral.org.

9/7/15

Family Practice Physician – Bucksport Regional Health Center                                                                

The Bucksport Regional Health Center, a Federally Qualified Health Center, has a unique opportunity for an experienced Family Practice Physician to work at a small, independent, community-based primary care facility that offers great quality indicators, a team atmosphere, and excellent working conditions.  Responsibilities will include the diagnosis, treatment, coordination of care, preventive care and provision of health maintenance services to patients of all life cycles. 

Candidates must have graduated from an accredited medical school and completed a residency in Family Practice or Med/Peds, have a current State of Maine Medical License and D.E.A Certificate, and at least five years of experience in the practice of family or internal medicine. The successful candidate will be offered a generous compensation package, including a competitive salary and excellent benefits. 

The Bucksport Regional Health Center has been offering easy access to quality, affordable care for persons of all ages since 1974.  Interested applicants should apply with a resume and cover letter to Carol Carew, Executive Director, 110 Broadway, Bucksport, ME 04416 or via email at ccarew@brhc.info (or call 207-469-7371).

8/17/15

Sebasticook Valley Hospital (SVH) is a 25-bed modern critical access hospital located in Pittsfield which is 20 minutes north of Waterville, and 40 minutes south of Bangor, Maine’s second largest city. The hospital serves a population of 30,000 in this central Maine area.

An excellent opportunity is available for a full time Emergency Medicine Physician.  The Emergency Medicine Physician is responsible for the evaluation and management of patients who seek emergency care for a broad range of illnesses and injuries. 

This is an experienced ED staff treating approximately 13,000 patients annually. Flexible schedule working 12-14 12-hr shifts. We are seeking either an MD/DO board certified/eligible emergency medicine trained physician, or board certified/eligible FP with ED experience. The hospital has EMR, and is CPOE. The compensation and fringe benefits package is highly competitive.

Sebasticook Valley is an affiliate of Eastern Maine Medical Center, the tertiary care center in Bangor. The hospital has a helipad for transporting trauma cases by Life Flight.  SVH serves has a wide range of outpatient services, including over 20 specialty services.

For more information, please contact Sherry Tardy, PHR, AASPR, at 207-487-4085 or stardy@emh.org.

9/14/15

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Upcoming Events

 American Academy of Pediatrics, Maine Chapter (MAAP) and the Atlantic Pediatric Society (APS) 

Joint Conference

September 25 – 27, 2015,  Friday 5pm through Sunday 12:30 pm

Algonquin Resort, St. Andrew’s, New Brunswick

Agenda and information about the venue:  http://maineaap.org/conferences/

Registration:  http://atlanticpediatricsociety.ca/register

Key Topics include: Child Death Review, Transitions of Care Adolescent to Adult, Cystic Fibrosis Screening, Child Advocacy, Child Protection, Hot Topics in Pediatric Medicine, and Pediatrics and Population Health

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

General Information for 2015

When and where held:                           

              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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