February 15, 2016

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New MMA Blog Goes Live!

The MMA Blog is now available for your reading and comments.

The Maine Medical Association is pleased to announce that we now have a blog! As part of our move to greater participation in web-based communication, we are publishing selected articles in blog form at www.mainemed.com/blog .You can also get to the blog by going to the home page of the MMA website and clicking on "Read our blog" in the top right corner of the page. Bookmark it to make access easier!

Readers are encouraged to comment on articles and participate in robust discussion of the issues they raise. It’s the MMA’s way to ensure our members have a greater voice on matters that come up in daily news and opinion pieces. As your state medical society we want to know what you think, and we’re committed to your participation in forming the Association's positions and advocating for all of Maine's physicians.

Protect Yourself from Identity Theft; File Your Tax Return Early

Well over one hundred Maine physicians (and usually their spouses) were unpleasantly surprised when they filed their federal tax returns for 2013 and 2014 and were told that their return had already been filed received and a generous refund sent to a prepaid debit card at an address now untraceable. Although the accurate returns were eventually processed and the victims of this scam were not held financially liable in any way, nonetheless the hassles associated with identity theft plagued these physicians and continue to be worrisome. Now that it is known that one's social security number, address and other personal information is in the hands of criminals, there is constant fear regarding when the next shoe will drop. 

One of the best ways to ensure that your return is the first return received by the IRS in your name and with your social security number, is for you to file your return as early as possible and not wait until the last minute. The IRS and state revenue departments are also becoming more sophisticated in identifying fraudulent returns so hopefully the filing of returns this year for the 2015 tax year will not result in as many surprises. 

During the last two years, the Maine Medical Association and other state medical societies, particularly our colleagues in New Hampshire, have collected the names of victims and shared information with the IRS and Secret Service. If you should be the victim of this scam, please communicate with MMA EVP Gordon Smith at gsmith@mainemed.com or by calling him at 207-622-3374 ext. 212. Attorney Smith recently participated in an national conference on identity theft and shared the Maine experience with attendees who were government officials from all over the country. The theft of identities for the purpose of fraudulently filing for local, state or federal benefits is now one of the fastest growing crimes in the world. While some of the criminal activity originates from other countries, there are now areas of our own nation where gangs of criminals buy identities on a regular basis for the purpose of using them at some future time. These identifications, which may include social security numbers, addresses, credit card numbers and other types of personal information, including medical information, may then be held for several years before they are used. Therefore, the typical offer from a retailer, insurer, hospital or other vendor of a year of free credit monitoring in the face of a data breach is not adequate. A known victim of a data breach should be monitoring their credit accounts and potentially use a credit monitoring service for several years. 

The sad truth is that probably all Americans have had their personal identification numbers stolen through one or more of the many very public and very large data breaches (Target, Anthem, the federal personnel system and thousands of others). It is only a matter of time before these numbers are sold to criminals who will begin to use the information to obtain benefits, cash or goods in the name of the victim. Constant vigilance is the best way to avoid widespread fraud in your name. 

It is also important to pay increased attention to the data of your patients that you are holding in your offices. Identity theft in the medical sector is now one of the major areas of focus for organized crime.  [return to top]

U.S. Attorney Thomas Delahanty and Maine Opiate Collaborative Members Present at MHA Small and Rural Hospital Forum

U.S. Attorney for the District of Maine Thomas Delahanty and four members of the Maine Opiate Collaborative presented the current status of the work of the Collaborative to attendees at the Maine Hospital Association's Small and Rural Hospital Forum last Friday, Feb. 12.  Speaking to a large group of hospital executives, Attorney Delahanty, Sagadahoc County Sheriff Joel Merry, MidCoast Addiction Recovery Center Director Eric Haram, MMA EVP Gordon Smith and Assistant U.S. Attorney and Narcotics Chief Daniel Perry shared the work of the three Task Forces established by the Collaborative around the topics of Treatment, Prevention/Harm Reduction and Law Enforcement.  The mission of the Collaborative is to develop recommendations for a comprehensive approach to the state's opioid/heroin crisis.

 Attorney Delahanty shared the latest statistics on accidental overdose deaths (approximately 250 in 2015, a significant increase from 2014) and babies born with indications of opiate use by the mother (illegal or with medical supervision (over 1,000 babies, again, an increase over the numbers in 2014).  Mr. Smith emphasized the low use of the Prescription Monitoring Program even after more than ten years of education regarding how to register and how to utilize it. With 80% of users of illegal opioids indicating that they began their downward spiral by taking legally prescribed medications (but not necessarily prescribed to them), it is imperative that all prescribers of controlled substances utilize the PMP on appropriate occasions.  The Maine Legislative is expected to consider bills mandating such use shortly.

Hospitals were asked to participate in the Community Forums being held across the state, organized by the Collaborative with funding from the Maine Health Access Foundation and the Maine Community Foundation. At least one Forum is being held in each of the nine public health districts in the state. [return to top]

POLITICAL PULSE: The Legislative Session Continues

The legislative session proceeds apace in Augusta. This past week saw more meetings with relevant stakeholders, administration officials and legislators on LD 690, the midwifery licensing bill. MMA attorneys Gordon Smith and Peter Michaud continue to participate, representing the voices of the MMA and the Maine chapter of ACOG. A hearing was held in the judiciary committee on LD 1311, a bill to establish a new “patient compensation system” that seeks to replace completely the current medical malpractice screening panel process with a state administrative system. This bill and others very similar to it are being promoted in six states around the country but have not yet passed in any state. Because our current Maine system has been functioning smoothly, with stability in rates over the past 10 years or so, the bill is opposed by the MMA, the Maine Hospital Association, Medical Mutual Insurance, the defense bar and the plaintiffs’ bar. In addition to the bill’s sponsor, testimony in favor of the bill was delivered by two witnesses representing the Georgia proponent of the bill and one Maine physician. Gordon Smith and Peter Michaud testified in opposition, along with several other representatives of medical interests in Maine. A work session has not yet been scheduled.

This coming week will see a public hearing on LD 1565, which seeks to make the office of medical examiner more attractive to Maine physicians, and LD 1488 concerning diversion of persons with substance use disorder from the legal system into treatment. Work sessions are also scheduled on a variety of bills, including several relating to the opioid problem and one which will require some level of periodic training for all mandated child abuse reporters, a group that includes physicians.

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MMA Presenting next CME Program on Opioid Prescribing and the PMP on March 11

On Friday, March 11, the Maine Medical Association, in cooperation with the Office of Substance Abuse and Adult Mental Health Services will present an educational program on prescribing for pain featuring a number of experts on issues ranging from community-wide guidelines for prescribing to the appropriate use of the Prescription Monitoring Program (PMP).  The program is being held from 9:00am to 12:45pm at the offices of MMA in Manchester, Maine.  The program is offered, AT NO COST, and is presented both live and via webex. Presenters include Noah Nesin, M.D., Medical Director at Penobscot Community Health Care, Lisa Letourneau, M.D., MPH, Executive Director of Quality Counts, Amy Belisle, M.D., Director of the Chronic Pain Collaborative at Quality Counts, John Lipovsky, MA, PMP Coordinator, Stephanie Nichols, Pharm.D, of Husson University School of Pharmacy and Clare Derosier, Director of Diversion Alert. The program will be moderated by MMA EVP Gordon Smith, Esq.

Registration is available on the MMA website at www.mainemed.com or by calling MMA at 622-3374. Three and one half hours of Category one CME is available by attending the program and completing the evaluation form.


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Opiate Collaborative Treatment Task Force Meetings: 2/18, 3/3 and 3/17; Prevention/Harm Reduction Task Force also Meets on 2/18

The next three meetings of the Maine Opiate Collaborative Treatment Task Force meetings will be from 9:00 to 11:00 am on February 18th, March 3rd, and March 17th.  The meetings will be held at the offices of the Maine Medical Association at 30 Association Drive in Manchester, Maine.  All the meetings are open to the public.

The topics featured at each of the upcoming meetings are as follows:

  •  February 18th:  Expansion of Medication Assisted Treatment (MAT) in the Primary Care Setting and Standardized Pain Management and Prescription Protocols;
  • March 3rd:  Expansion of Medication Assisted Treatment (MAT) in Substance Abuse Treatment and Treatment for Adolescents;"
  • March 17th:  Treatment for Women and Infants and the Criminal Justice System.

 The Treatment Task Force is co-chaired by Pat Kimball and Eric Haram.  Minutes of the meetings are posted on the website of the U.S. Attorney's Office for the District of Maine.

The Prevention/Harm Reduction Task Force also will meet at the offices of the Maine Medical Association this Thursday, February 18th at 1 p.m.

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Next MMA Weekly Legislative Committee Conference Call is Tuesday, February 16th at 8 p.m.

MMA Legislative Committee Chair Amy Madden, M.D. welcomes you to participate in the weekly conference calls of the MMA Legislative Committee.

The next MMA Legislative Committee weekly conference call for the Second Regular Session of the 127th Maine Legislature will take place tomorrow, Tuesday, February 16th 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:  1-302-202-1092

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 is a report generated through our tracking system software program called StateTrack from CQRoll Call.  Please click on the report link and you should go to the bills highlighted by MMA staff for review from the bills printed that day.  You will be able to click on a link to the text of the bill for review and you will find the same staff recommendations you have seen in the past - a suggested category or "profile," a suggested position (support, monitor, or oppose), and any medical specialty society or MMA committee that might have a particular interest in the bill.

There are no new bills for review this week, but the staff will provide an update on current activities at the State House.

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Avoid Meaningful Use Penalties: Apply for Exemption by March 15th

Physicians have until March 15th to apply for a hardship exemption from the electronic health record (EHR) meaningful use financial penalties for the 2015 program year.  Those who don’t apply could face up to a 3 percent cut in their Medicare payments in 2017 since the meaningful use program operates on a two-year look-back period.  New this year, individuals can apply on behalf of a group of physicians.

Everyone should apply:  The Centers for Medicare & Medicaid Services (CMS) has stated that it will broadly grant hardship exemptions as a result of the delayed publication of the Stage 2 meaningful use modifications rule, which left physicians with insufficient time to report under the modified program requirements issued in late 2015.

This inclusive approach to hardship exemptions is a result of the Patient Access and Medicare Protection Act, passed just before Congress adjourned for the holidays, which directed CMS to make AMA-supported changes to the previously limited exemption process.

All physicians should apply for the exemption since there isn’t a downside to doing so.  Even physicians who believe they met the requirements of the meaningful use program in 2015 can apply.  Submitting an application for a hardship exemption will not prevent those who qualify from receiving an incentive payment.

How to apply:  Physicians should be sure to submit their applications before midnight Eastern Time on March 15, 2016.  To get started, download an application from CMS and consult step-by-step instructions (log in) the AMA compiled to help simplify the submission process.

While CMS has given a deadline for applications, it has not yet indicated when physicians will receive confirmation of their exemption status.
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Upcoming Events

MCMI Training Programs – Level 1 and Level 2

General Information for 2016

When and where held:


              March 11, 2016 in Bangor at St. Joseph’s Hospital  

              April 8, 2016 in Presque Isle at UMPI                   

              June 10, 2016 in Waterville at Colby College

              October 25, 2016 in Portland in conjunction with the Maine Brain Injury Conference

                                (Registration and fees will be through the Maine Brain Injury Conference for October 25)

                 March and April programs will be morning only with Level 1 and Level 2 at the same time.

               June and October programs will be Level 1 in the morning and Level 2 in the afternoon.


Training Programs:


              Level 1 – An Introduction to Concussions and Concussion Management

                            Speaker: Deb Nichols, CPNP or Peter Sedgwick, MD or Bill Heinz, MD

                           Level of Difficulty: beginner

                           Content: The Diagnostic and Return to Play Dilemma

                                           How Concussion Occurs and Pathophysiology            

                                           Concussion Signs and Symptoms

                                           Concussion Evaluation Tools

                                           Concussion Treatment

                                           Recovery Epidemiology

                                           Return to Function – Academics and Play

                                           Risk Factors and Protective Equipment

                                           Short and Long Term Sequelae

                                           Neurocognitive Testing

                                           Concussion Sideline Assessment

                                           Key Points


              Level 2 – Advanced Concussion Management (Level 1 is a prerequisite for taking Level 2)

                           Speaker: Mike Rizzo, FNP-C, CIC or Paul Berkner, DO

                           Level of Difficulty: intermediate

                           Content: Updates from Zurich 2012       

                                           Using ImPACT Testing in Concussion Management

                                           Interpreting ImPACT Test Results

                                           Concussion Case Reviews


              March and April – Level 1 and Level 2 (Offered at same time)

                           8:00am – 8:15am           Registration

                           8:15am – noon               Training Program


              June – Level 1:

                           7:45am – 8:00am           Registration

                           8:00am – noon               Training Program

                           Level 2:

                           12:15pm-12:30pm          Registration

                           12:30pm – 4:30pm         Training Program


Registration Fee:           

              For morning only training programs: March 11 and April 8

              $100 for Health Care Professionals (MD, DO, NP, PA, Neuropsychologist, AT, 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


              For morning and afternoon training program: June 10

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

              $175 for Health Care Professionals taking Level 1 and Level 2 - Only June 10


              $40 for school personnel and all other attendees                                                                                                              (School nurses, coaches, athletic directors and administrators, etc.)

              $70 for school personnel taking Level 1 and Level 2 - Only June 10


              $20 for students currently enrolled in a college program            

              $35 for students taking Level 1 and Level 2- Only June 10

CME/CEU contact hours: 3.50

Registration Confirmation will be sent by email.

Refund / Cancellation Policy: If you need to cancel contact Jan Salis, PT, ATC. You can choose to apply your registration fee to another training program or have your check returned.

For more information contact:

              Jan Salis, PT, ATC

              MCMI - Membership and Education Committee - Chair


              (207) 577-2018


MAT for Multidisciplinary Teams: Things You Need to Know in the Development and Delivery of Buprenorphine Services

This program brings experts who are providing buprenorphine services in Maine to share their knowledge about addiction and what is needed to develop quality MAT services.

Presenters: Dr. Leah Bauer, MD, a psychiatrist and Medical Director of the Addiction Resource Center at Midf Coast Hospital in Brunswick; Eric Haram, LADC, Director of Outpatient Behavioral Health at Mid Coast Hospital.

 5.5 Contact Hours Available
Click here for details. Certificates will be emailed to participants who attend the entire program. No partial credit will be given.

Training Objectives

  • Describe the basics of addiction and what happens in the brain around tolerance, affinity and withdrawal from opioids
  • Name key elements of safe and effective practice for the delivery of buprenorphine services
  • Identify roles and functions within teams for delivering MAT
  • Analyze how to finance and sustain your MAT program

Registration will begin at 8:30 a.m.

Lunch will be on your own.

This course is sponsored by CCSME through the Maine Behavioral Health Workforce Development Collaborative, a partnership between AdCare Educational Institute of Maine, Co-Occurring Collaborative Serving Maine, and Muskie School of Public Service with funding from the Maine Office of Substance Abuse and Mental Health Services (SAMHS), Department of Health and Human Services.

Wednesday, March 9, 2016 from 9:00 AM to 4:00 PM (EST) - Add to Calendar

Husson University - 340 County Road Westbrook, Maine 04092 - View Map


Printable Registration Form: https://cdn.evbuc.com/eventlogos/3100087/20160309registrationform-1.pdf

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Job Openings

Relocate to Beautiful Southwestern Maine

Full-time family practice physician wanted for multi-service, progressive, rural federally qualified community health center in a medically underserved area. Services on site include integrated primary care, dental services, family planning, mental health counseling, psychiatry, nutritionist, optometry, podiatry, social services support, sliding fee coverage, care management, radiology and lab services. NextGen EMR. Practice is outpatient only with no OB. On-call rotation is 4-5 times per month. NCQA Level III PCMH. Located in Porter, ME, between Portland and the White Mountains. Area is known for terrific four season recreational activities. Just two and one-half hours from Boston. Submit CV to: Nancy Buck, Human Resources Coordinator, (nbuck@svhc.org), Sacopee Valley Health Center, 70 Main Street, Porter, ME 04068. EOE. www.svhc.org Sacopee Valley Health Center is an equal opportunity provider and employer .


EXECUTIVE DIRECTOR - Sacopee Valley Health Center

Sacopee Valley Health Center, a federally qualified health center located in Porter, Maine, seeks a full-time Executive Director to provide leadership, overall direction, and management of programs, operations, and finances of the Corporation.  Advanced degree in healthcare administration field and/or business administration with two to five years senior management experience, preferably in health care or equivalent combination of education and management experience is required; not for profit management experience preferred. Anticipated start date is June 1st. 

Submit resume and letter of interest by February 19th to:  nbuck@svhc.org or Human Resources Coordinator, Sacopee Valley Health Center, 70 Main Street, Porter, ME 04068 Sacopee Valley Health Center is an Equal Opportunity Provider and Employer



Northern Maine Medical Center, a 49-bed JCAHO accredited hospital nestled in the foothills of the St. John Valley, is seeking a General Surgeon to provide general surgical care. Must be able to do endoscopies and C-sections. Endoscopy Suite and 2 operating rooms.  Maine Medical licensure or immediate eligibility for licensure required.  Area offers a casual, laid-back lifestyle in a crime-free environment which is a great place to raise a family. Interested candidates should send CV to  Dorine Deschaine, Recruiter, Northern Maine Medical Center, 194 East Main St. Fort Kent, ME  04743 or  e-mail to: dorine.deschaine@nmmc.org or call at (207) 834-1434.  Equal Opportunity Employer.



Northern Maine Medical Center, a 49-bed JCAHO accredited hospital nestled in the foothills of the St. John Valley, is seeking a Hospitalist to provide inpatient care. MD/DO, BE/BC in internal medicine, and Maine Medical licensure or immediate eligibility for licensure required.  Area offers a casual, laid-back lifestyle in a crime-free environment which is a great place to raise a family. Interested candidates should send CV to Dorine Deschaine, Recruiter, Northern Maine Medical Center, 194 East Main St., Fort Kent, ME  04743 or e-mail to: dorine.deschaine@nmmc.org or call at (207) 834-1434.  Equal Opportunity Employer.



Northern Maine Medical Center, a 49-bed JCAHO accredited hospital, Psychiatric Units; 9-bed Adult, 7-bed Child, is seeking a Psychiatrist to provide inpatient/outpatient care. Maine Medical licensure or immediate eligibility for licensure required.  Area offers a casual, laid-back lifestyle in a crime-free environment which is a great place to raise a family. Interested candidates should send CV to Dorine Deschaine, Recruiter, Northern Maine Medical Center, 194 East Main St., Fort Kent, ME  04743 or e-mail to: dorine.deschaine@nmmc.org or call at (207) 834-1434.  Equal Opportunity Employer.


Experienced Internist or Family Physician Wanted for Per Diem Work 

Southern Maine Geriatrics Associates (SMGA) is recruiting physicians to work for physicians and midlevel providers during vacations and CME in a long term care practice in skilled/rehab, nursing home and assisted living.  Great work-life balance.  No call, no weekends, no holidays with hours typically 8 to 5.  Southern Maine Geriatrics provides geriatric medical care to residents in facilities in southern and central Maine.   Must have current Maine license, DEA, and meet hospital credentialing requirements.  Interested candidates should send their CV to Susan Pratt, Southern Maine Geriatrics Associates, 50 Marquis Road, Freeport, ME  04032,pratts@smga.me.  


E.M. BC/BP Physicians

St. Joseph Hospital is recruiting E.M. BC/BP physicians for its dedicated group.  Collegial, nurturing workplace with latest technology and just-completed expansion.  Members support each other and know patient satisfaction is achieved through staff satisfaction.  Leadership development and participation in policies and direction available. 

Equitable scheduling based on 1440-1472 clinical hours per year; more flexible arrangements available. 

Staffing: 51 hours per day, mostly physicians, for 27,000 visits.  We have great E.D. nurses.   

Area offers many cultural attractions, including the University of Maine, natural and organic food producers, pleasant pace, low crime, friendly people, great public schools and affordable housing.  Acadia National Park, Baxter, scenic towns and harbors, Sugarloaf,  I-95 and Bangor International Airport are right here or close.

Highly competitive package includes relocation, signing bonus, loan repayment, retirement and protected vacation and CME time with allowance.

Contact: Charles F. Pattavina, MD, F.A.C.E.P., Chief, Emergency Medicine at 207.907.3350  or cpattavina@sjhhealth.com


Family Medicine/ Outpatient Internal Medicine Physician

As a result of our continuous growth, Katahdin Valley Health Center is recruiting a Family Medicine/ Outpatient Internal Medicine Physician that is committed to providing quality health care services to the people in Brownville/Millinocket Maine.   Join our practice in a newly renovated facility.  KVHC is a fully electronic medical record site and offers a four day work week with a competitive salary 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. Physicians who join KVHC are eligible to apply for NHSC Loan Repayment.  

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.


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CMS Issues DMEPOS Prior Authorization Final Rule

The Centers for Medicare & Medicaid Services (CMS) recently released a final rule that establishes a prior authorization process for certain durable medical equipment, prosthetics, orthotics and supplies (DMEPOS).

The final rule does not create any new clinical documentation requirements but will require physicians to submit information supporting Medicare payments for certain items prior to those items being furnished to a beneficiary. These items will be selected by CMS from a “master list” of items identified by the agency as being frequently subject to unnecessary utilization.  A list of the items targeted for prior authorization will be published by the agency with 60 days’ notice before prior authorization is required.

Under the final rule, CMS notes that it will “make reasonable effort” to provide a prior authorization determination to providers within 10 business days of submission.  Physicians will be allowed unlimited resubmissions, and an expedited review process will be available where delay could jeopardize the life or health of the beneficiary.

The AMA continues to oppose the use of prior authorization programs by payers and has worked diligently to limit the use of these controls.  In a July 2014 comment letter to CMS (log in) addressing the DMEPOS prior authorization proposed rule, the AMA opposed this program because of the administrative burdens it would place on physician practices and the negative impact on patient access to care.  The AMA urged CMS to shorten prior authorization response times, restrict the program to a small number DMEPOS items, and limit application of the program to statistical outliers instead of broadly requiring prior authorization of all physicians.  
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For more information or to contact us directly, please visit www.mainemed.com l ©2003, Maine Medical Association