February 29, 2016

 
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Major Legislation Expected Soon on Prescribing Limits and Mandated Education and Use of the PMP

The other shoe is about to drop this week at the State House with respect to opioid prescribing and mandated education and use of the Prescription Monitoring Program (PMP).  The impact on patients and prescribers is likely to be significant.

The Prescription Monitoring Program (PMP) is receiving attention from the legislature and Governor LePage in the face of data released from the Program indicating that only 7% of those prescribers registered for the Program are regularly using it.  While the 7% figure is subject to analysis and explanation, legislators are likely to consider proposals to mandate use of the PMP as a tool for preventing doctor shopping rather than just mandating registration.  The PMP now has been in operation for more than a decade and with the opioid/heroin crisis still a serious public health problem, legislators and the Governor are expected to take some action.

In the event that legislation mandating use is considered, MMA has prepared an alternative proposal sponsored by Senator Roger Katz (R-Kennebec) that would direct the health professional licensing boards to mandate use by amending existing Joint Rule 21, Use of Controlled Substances for the Treatment of Pain which already provides guidelines when prescribing controlled substances for pain.  By using the rulemaking process at the licensing boards, physicians would have an opportunity to provide input during a reasonable period of time.  MMA also has suggested that the effective date for any such mandate not be before July 1, 2017 in order to give all prescribers an opportunity to be educated to the new standard.

The 7% figure is suspect because the denominator now includes all licensed health professionals who have prescribing privileges even if they do not have a DEA number and thus do not prescribe controlled substances.  If only prescribers who are regularly prescribing controlled substances are included, the 7% number would be much higher.  In addition, the usage number is diminished by virtue of the fact that some prescribers in a system of care may use delegates to access the PMP and assign those delegates to more than one physician.  Nonetheless, not all prescribers are using the PMP who should be.  And, over-prescribing continues to be an issue, as well.

The Katz bill and a bill being presented by the Governor are both expected to be printed and presented to the Legislature this coming week.  The Governor's bill is likely to be very far-reaching and limiting the prescribing of opiate based medication as well as mandating education and regular use of the PMP.  Watch next week's Update for more details and hearing dates.

 
 

Baystate Financial Presents Seminar on Social Security Claiming Strategies Before Critical April 30th Date!

MMA's financial services partner, Baystate Financial, is offering several seminars on What You Need to Know about Social Security Claiming Strategies in the coming weeks.   Anthony Bartlett, ChFC, CASL, AEP of Baystate Financial will be the faculty for these complimentary events.  

Understanding the nuances of Social Security benefits has always been challenging . . . . and the new Federal budget created major changes to certain claiming strategies.  As a result, the complex set of rules are - more than ever - difficult to navigate alone.  

During this workshop, financial advisor Anthony Bartlett will walk you through:

  • How Social Security retirement benefits are calculated;
  • Which claiming strategies are being eliminated or severely curtailed after April 29, 2016; and
  • What actions you should take now, regardless of your age.

The workshop dates are:

Wednesday, March 2, 2016, 5:00 - 6:30 p.m.

Maine Medical Association, 30 Association Drive, Manchester, Maine

and

Thursday, March 10, 2016, 6:00 - 8:00 p.m.

Salt Water Grille, 231 Front Street, South Portland, Maine

There is no fee to attend, but pre-registration is required.  To register, please email Larry Perry at lperry@baystatefinancial.com or call 207-775-6181.

For more information on Baystate Financial click here. [return to top]

SAVE THE DATE: MMA's 2016 Benefit Golf Tournament will be Monday, July 18th at Augusta Country Club

MMA's Annual Benefit Golf Tournament will be held this year on Monday, July 18, 2016 again at the Augusta Country Club in Manchester.  Proceeds will benefit the medical school scholarship fund.  The event will begin with lunch on the deck with a shotgun start at noon in a traditional scramble format.  An incorrect date was listed in the most recent issue of MMA's Maine Medicine.

To reserve a spot for yourself or your foursome, or to learn about sponsorship opportunities, contact Lisa Martin at MMA at 622-3374, ext. 221 or via e-mail to lmartin@mainemed.com.

 

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U.S. Senate Confirms Robert M. Califf, M.D. as FDA Commissioner

The United States Senate confirmed Robert M. Califf, M.D. to lead the Food & Drug Administration (FDA) last Wednesday by a vote of 89 to 4.  Senators voting against the appointee indicated that they were concerned that Califf was not well suited to address the increased levels of opioid abuse around the country because of his ties to the pharmaceutical industry.  You can read more about Dr. Califf on the Duke University School of Medicine web site here.
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Health Insurance Marketplace Update

The 2016 Open Enrollment period for the Health Insurance Marketplace ended on January 31, 2016.  The next Open Enrollment period for 2017 health insurance plans through the Marketplace will start in the fall of 2016.

Outside of Open Enrollment some people may be eligible for a Special Enrollment Period if they have a life event such as getting married, having a child, or losing other health coverage.  For more information and Marketplace enrollment assistance:

For more information, contact Susan Kring, ACA Outreach Coordinator at 662-2364 or skring@mainemed.com. [return to top]

POLITICAL PULSE: Opioid Abuse Issue Continues to Dominate Health Debate

The Second Regular Session of the 127th Maine Legislature continues with an anticipated adjournment in mid-April.  As the lead article in this week's Update suggests, the opioid abuse epidemic has been the dominant issue in the health policy debate this session and a significant piece of legislation on the topic from the Governor is anticipated soon.

In other activity, the MMA has submitted a letter in opposition to L.D. 1518, a bill before the Judiciary Committee that would create a new legal framework for consent to treatment of minors who are in temporary custody of a "caretaker relative," such as a grandparent.  The bill would introduce a new document called a "caretaker relative medical authorization affidavit" to be interpreted by busy health care practitioners.  Rather than adding this new legal framework to current law regarding powers of attorney and guardianship proceedings, the MMA is suggesting that the bill's stakeholders develop a new provision of statute that would provide such "caretaker relatives" with a limited right to consent to treatment of minors in their care.  This week, the Judiciary Committee also will hold a work session on L.D. 1311, the bill proposing an alternative means of resolving medical negligence claims in Maine.  The bill is opposed by all of the major stakeholders in the medical liability debate - the MMA, the Maine Hospital Association, the Medical Mutual Insurance Company of Maine, the Maine Trial Lawyers Association, and others. 

 Last week, MMA legal extern Cora Best, a third-year law student at the University of Maine School of Law, delivered the MMA's testimony in favor of L.D. 1547, a bill that would make naloxone available without a prescription, before the Health & Human Services.  Cora did an excellent job in presenting her first testimony before the Maine legislature.  She joined many other speakers from the prevention and harm reduction communities, including Lani Graham, M.D., M.P.H.  The HHS Committee will work the bill this week.  The HHS Committee also held a work session last week on L.D. 633, Sen. Tom Saviello's (R-Franklin) bill on ACA Medicaid expansion, that was carried over from the First Regular Session.  MMA and the Cover Maine Now coalition supports the bill.  The Committee vote on the bill is expected to be a party line 7-6 "ought to pass as amended" report with Democrats in the majority and Republicans in the minority.  

 Finally, the MMA continues to work with other interested parties in continuing negotiations of L.D. 690, the bill proposing licensure for certified professional midwives (CPMs) that is before Labor, Commerce, Research & Economic Development Committee. [return to top]

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

On Friday, March 11th, the Maine Medical Association, in cooperation with the Office of Substance Abuse & 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 9:00 am to 12:45 pm 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., M.P.H., Executive Director of Quality Counts, Amy Belisle, M.D., Director of the Chronic Pain Collaborative at Quality Counts, Stephanie Nichols, Pharm.D., of Husson University School of Pharmacy and Clare Desrosier, 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.  3.5 hours of Category one CME is available by attending the program and completing the evaluation form.

 

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Next MMA Weekly Legislative Committee Conference Call is Tuesday, March 1st 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, March 1st 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.

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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HHS Issues HIPAA Guidance on Uses of Health Information

New fact sheets on permitted uses and disclosures of protected health information (PHI) for treatment and health care operations purposes under the Health Information Portability and Accountability Act (HIPAA) were released by the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) and Office of the National Coordinator for Health IT (ONC).  HIPAA generally permits physicians to use and disclose protected health information for treatment and health care operations without first obtaining a patient’s written authorization. 

The fact sheets were announced in the first of a series of blog posts created to correct misunderstandings about HIPAA, address physician concerns related to the exchange of PHI in the absence of patient authorization and demonstrate how HIPAA supports interoperability by allowing the transfer of electronic PHI through Certified Electronic Health Record Technology or other electronic means.

The AMA has also created a toolkit on related aspects of HIPAA, which includes the requirements around privacy and security.
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Meaningful Use Attestation Deadline Extended

Physicians now have an additional two weeks to attest to meaningful use for the 2015 program year.  The Centers for Medicare & Medicaid Services (CMS) extended the original February 29th attestation deadline to midnight Eastern time March 11th.

Physicians must attest to meaningful use every year to receive an incentive payment and avoid a penalty.  Note that CMS is only extending the attestation period, not the reporting period, so physicians must have concluded their reporting by December 31, 2015.

To attest, physicians should submit their data through the CMS registration and attestation system.  Physicians may select an EHR reporting period of any continuous 90 days from January 1, 2015, (the start of the 2015 calendar year) through December 31, 2015. 

To speed the attestation process, the AMA recommends that physicians attest during off-peak hours, such as evenings and weekends, and take time now to ensure that their information is up-to-date before beginning to enter 2015 data.

As a reminder, the AMA is encouraging all physicians to apply for a hardship exemption as a result of the delay of the 2015 meaningful use modification rule.  The AMA has confirmed with CMS that applying for the hardship exemption will not preclude physicians from receiving the incentive if they successfully attest.  In essence, the hardship exemption will act as a safety net.   [return to top]

Job Openings

PHYSICIAN/MEDICAL DIRECTOR - Nasson Health Care

Nasson Health Care is seeking a qualified clinical leader to work collaboratively with a team of health and administrative professionals to provide comprehensive primary care to patients while utilizing the Patient-Centered Medical Home model of care delivery.  

The Physician/Medical Director: 

  • Provides advice and counsel regarding a broad range of clinical, clinical policy, programmatic and strategic issues required to achieve the short and long-term strategies and objectives of Nasson Health Care; 
  • Provides direct clinical services and oversees physicians and advanced practice nurses; works in partnership with members of the practice team to manage the care of patients, assuring a high standard of medical care; 

  Qualifications include:

  • A minimum of three years’ experience as a Medical Director of a primary care medical practice;  A degree from an accredited medical school in the U.S.,
  • Board certification in Family or Internal Medicine;  An unrestricted Maine license to practice medicine, as well as a U.S. Drug Enforcement Agency license;
  • Working knowledge of the core concepts of evidence-based practice, social and behavioral determinants of health, population-based care, integration of medical, behavioral health and dental care, and Meaningful Use of health information technology.

Visit http://www.nassonhealthcare.org for an application. Completed cover letter, resume, and employment application will be accepted until position is filled.

4/25/16

HOSPITALIST - Brunswick, ME

Mid Coast Hospital is seeking a full time Hospitalist to join its established hospitalist service, which is expanding due to growth. The candidate should be BC/BE in internal medicine or family practice. New graduates and experienced candidates are encouraged to apply. Procedures are not required. Excellent Intensivist and subspecialist support is available. Part-time and per diem applications will be considered. 

Part of the Mid Coast–Parkview health family of services, Mid Coast Hospital offers competitive benefits and compensation package, along with an excellent work environment. Please send CV to Melanie Crowe, Physician Recruiter, at mcrowe@midcoasthealth.com or call (207) 406-7872, for more information.

4/18/16

OUTPATIENT FAMILY MEDICINE - Brunswick, ME

Mid Coast Medical Group is seeking a BC/BE Outpatient Family Practitioner to join our multi-specialty group. Admitting is through a high-quality Hospitalist service.

The Coastal location, historic neighborhoods, superior schools, and Bowdoin College campus make this part of Maine a very desirable place to live. 

Part of the Mid Coast–Parkview health family of services, Mid Coast Medical Group offers competitive benefits and compensation package, along with an excellent work environment. Please send CV to Melanie Crowe, Physician Recruiter, at mcrowe@midcoasthealth.com or call (207) 406-7872, for more information.

4/18/16

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 .

3/7/16

GENERAL SURGEON

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.

2/29/16

HOSPITALIST

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.

2/29/16

PSYCHIATRIST

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.

2/29/16

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

7/18/16

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.

5/23/16

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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

Schedule:

              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

              jsalis@aol.com

              (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.

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

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