March 14, 2016

 
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Public Hearings on Opioid Prescribing Limits Wednesday

The Legislature's Health & Human Services Committee has scheduled public hearings on L.D. 1646 and L.D. 1648 for this Wednesday, March 16th at 1:00 pm.  The Governor's proposal, L.D. 1646, would establish a number of limits on prescribing for pain with opioid medication.  It would also require prescribing of such medication by electronic means, effective January 1, 2018.

The second bill, L.D. 1648, is sponsored by State Senator Roger Katz (R-Kennebec) and offers an alternative approach to the Governor's bill.  The Katz bill would also provide limits to opioid prescribing but would accomplish them through the health related licensing boards, which would allow for an approach more attuned to the needs of prescribers.  The Katz bill also would require that pharmacists register with the Prescription Monitoring Program (PMP) as data users, as all prescribers are required to do under present law.  The bill also would allow for the exchange of data with the Canadian provinces.

The Governor's bill is very broad and would impact all prescribers of opioids and benzodiazepines.  Specifically, the bill would:

1. Provide for prescriber immunity from liability for disclosure of information to the Prescription Monitoring Program (PMP).

2. Provide that upon initial prescription of a benzodiazepine or an opioid to a patient, and for every 90 days for as long as the prescription is renewed, a prescriber must check the PMP for records related to that patient.  A prescriber who violates this provision is subject to a fine of $250 per incident, not to exceed $5,000 per calendar year.  A similar provision requires pharmacists and other dispensers to also check the PMP before dispensing a new script.

3. Provide that the failure of a health care provider who is a prescriber or dispenser to check the PMP or to submit prescription monitoring information to HHS as required by the law is grounds for discipline of the provider.

4. Require that by December 31, 2017 and every 5 years thereafter, a health care provider who is a prescriber must successfully complete a training course on the prescription of opioid pain medication that has been approved by DHHS as a condition of prescribing such medication.

5. Most significantly, establish limits on the amount of opioid medication that may be prescribed to a patient. Prescriptions could not be in excess of 100 morphine milligram equivalents per day to any one patient and a prescriber may not prescribe within a 15 day period more than a 15-day supply to a patient under treatment for chronic pain and not more than 3-day supply within any three day period to a patient under treatment for acute pain.

6.  Beginning January 1, 2018, opioid medication for pain could only be prescribed electronically.

If enacted, these restrictions on prescribing would be the most restrictive in the nation.  Because the bills were just printed this past Thursday, the MMA Legislative Committee and staff are still reviewing the bills and receiving input from members.  A final position will be established on the weekly legislative call on Tuesday (tomorrow) night at 8:00 pm.  Any MMA members may join that call.  If you would like to provide comments to MMA or to the Legislature through MMA, please communicate directly with EVP Gordon Smith at 215-7461 (cell) or via e-mail to gsmith@mainemed.com.  

 
 

The Physicians Foundation Invites More Than 650,000 Physicians to Participate in Fourth National Survey

Survey Will Inform a “State of the Union” of the Medical Profession

Boston, March 1, 2016 – The Physicians Foundation, a non-profit organization that seeks to empower physicians to lead in the delivery of high-quality, cost-efficient healthcare, is launching its fourth national Survey of America’s Physicians, one of the largest physician surveys ever undertaken in the United States.

“This is the one national survey that allows physicians to share their perspective on the state of the medical profession,” said Walker Ray, M.D., president of the Physicians Foundation. “We’d like to hear from as many physicians as possible so we can accurately understand – and share with the public – physicians’ perspectives on the most significant issues in medicine and healthcare today.”

The survey is being conducted by national physician search and consulting firm, Merritt Hawkins, and will be emailed to more than 650,000 physicians across the country from March-May of 2016. The survey will take approximately 10-12 minutes to complete and will allow physicians to share their thoughts on health reform, electronic medical records, new methods of physician reimbursement, ICD-10, and a variety of other topics. A full copy of the final survey report will be emailed to all physicians who participate, and participants will also be entered to win one of five $500 Amazon gift cards and one $5,000 Amazon gift card.

Physicians can access the survey via this link: https://amnhealthcare.co1.qualtrics.com/jfe3/form/SV_bk1BYfVr1FDaOIR

To access previous Physicians Foundation surveys, visit www.physiciansfoundation.org.

About The Physicians Foundation

The Physicians Foundation is a nonprofit 501(c)(3) organization that seeks to empower physicians to lead in the delivery of high quality, cost efficient healthcare. It pursues its mission through a variety of activities including grantmaking, research, white papers and policy studies. Since 2005, the Foundation has awarded numerous multi-year grants totaling more than $37 million. In addition, the Foundation focuses on the following core areas: physician leadership, physician practice trends, physician shortage issues, and the impact of healthcare reform on physicians and patients. As the healthcare system in America continues to evolve, The Physicians Foundation is steadfast in its determination to strengthen the physician-patient relationship and assist physicians in sustaining their medical practices in today’s practice environment. For more information, please visit www.PhysiciansFoundation.org and follow the Foundation on Twitter at @PhysiciansFound to stay informed on the latest news.

About Merritt Hawkins

Merritt Hawkins is the leading physician search and consulting firm in the United States and is a company of AMN Healthcare (NYSE: AHS). For more information, visit www.merritthawkins.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.  The opioid abuse epidemic continues to be the dominant issue in the health policy debate this session and two significant pieces of legislation on the topic, LD 1646 and LD 1648, were printed last week.  LD 1646, a "Governor's bill," calls for significant limits on frequency and amounts of opioids that could be prescribed, and it also sets civil fines for a prescriber's failure to check the Prescription Monitoring Program (PMP).  The limits, if passed as drafted, would be the strictest in the nation.  LD 1648, submitted by Senator Roger Katz, (R-Kennebec), would require the various health care licensing boards to take charge of the situation and set similar limits.  It would also include pharmacists and veterinarians as mandated users of the PMP and would provide for the sharing of prescription information with the Canadian provinces.  Both bills are set for public hearing in the Health & Human Services (HHS) Committee on Wednesday, March 16th, at 1:00 p.m.  Significant negotiation of the various parts of the two bills is expected both before and after the public hearing and the work sessions, the first of which is scheduled for Friday morning at 10:00 am.

Possibly the highlight of the past legislative week was Governor Paul LePage's appearance before the HHS Committee on Friday morning to comment on L.D. 1577, a bill that would move violent Riverview Psychiatric Center patients adjudicated as "Incompetent to Stand Trial (IST)" or "Not Criminally Responsible (NCR)" to the Intensive Mental Health Unit at the Maine State Prison in Warren.  The Governor stated, "It's not a complex issue."  He felt that such forensic patients do not require a hospital level of care and so do not belong at Riverview, although "they need to be put somewhere."  He reported hearing from judges in Miami and South Dakota that 98% of persons who are sent to a similar unit do not reoffend, and that these persons need the increased security levels due to their violent behaviors.  He stressed that it is better for such persons to stay in Maine, near their family support systems, than to be sent to hospital treatment facilities in other states.  The bill failed to pass the committee on a party line, 7-6 vote.  It's next stop will be the full House and Senate where both minority and majority reports may be considered.

Last week the Judiciary Committee held a second 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.  The Committee voted 11-2 "Ought Not to Pass."  Some legislators commented that Maine's current prelitigation screening panel process is working very well for all stakeholders and should not be tampered with in the name of experimentation. 

Finally, the Judiciary Committee also voted unanimously to pass an amended version of L.D. 1518, a bill to address the difficult issue of obtaining proper consent to medical treatment for a minor who is estranged from parents and living with another relative, such as a grandparent or aunt/uncle, but where no health care power of attorney or guardianship order is in place.  Rather than introducing a new document, known as a caretaker relative medical treatment affidavit," as the original bill suggested, the revised bill would establish the statutory right of a "surrogate" to make medical treatment decisions under certain limits.  The MMA worked on the amended bill language with representatives of the Maine Hospital Association, Legal Services for the Elderly, and the University of Maine School of Law.


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Governor Appoints Two New Members to Board of Licensure in Medicine

Governor Paul LePage recently appointed two new members to the state's medical licensing board.  Brad Waddell, M.D., a board-certified general surgeon practicing at Eastern Maine Medical Center in Bangor, was appointed to a six-year term replacing David Andrews, M.D. who resigned in 2015.  Dr. Waddell is a graduate of Wake Forest Medical School.

Also appointed was a public member, Ms. Lee Corbin.

The Board of Licensure in Medicine has ten members, made up of six physicians, one physician assistant, and three public members.  The Board meets the second Tuesday of each month at its offices in Augusta.

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MMA Blog Post on Naloxone Laws

The MMA blog features a new post on naloxone prescribing and use.  It includes discussion of the various Maine statutes on the subject along with reference to a pending bill that would allow naloxone to be dispensed "behind the counter."  You can read it here. [return to top]

MMA Welcomes Employed Physicians at Downeast Community Hospital

The employed physicians at Downeast Community Hospital in Machias all recently became MMA members through a group membership purchased by the hospital. Ten new members have joined the nine existing members. If you would like more information on MMA's group membership program, contact MMA EVP Gordon Smith via e mail to gsmith@mainemed.com

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Sequestration Cuts to Continue

The Centers for Medicare & Medicaid Services (CMS) has annou nced that 2% sequestration cuts on Medicare Part B claims will continue until further notice.  These cuts began April 1, 2013, as part of across-the-board cuts in federal agency spending caused by the sequestration process.  The 2% cut also applies to costs for drugs administered by the physician.

For physicians who participate with Medicare Part B, the cut affects 80% of the allowable charge; beneficiary co-payments and deductibles are not effected.  The cuts also do not effect non-participating physicians' billing: CMS applies the 2% to the payment made to the patient under this circumstance.

 

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Next MMA Weekly Legislative Committee Conference Call is Tuesday, March 15th 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 15th 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 two important bills on the state's opioid abuse problem will be the focus of this conference call:

 LD 1646, An Act To Prevent Opiate Abuse by Strengthening the Controlled Substances Prescription Monitoring Program (support with caveats); and

LD 1648, An Act To Amend the Laws Governing the Controlled Substances Prescription Monitoring Program and To Review Limits on the Prescription of Controlled Substances (support).


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New Guidance on Meaningful Use Reporting

As a result of the AMA’s request for clarification around the new Public Health-Clinical Registry objective finalized in the 2015-2017 electronic health record (EHR) meaningful use modification rule, the Centers for Medicare & Medicaid Services recently published frequently asked questions (FAQ) clarifying the requirements.

The FAQs include new and updated answers about when physicians can register their intent to report to a registry, what physicians should do in 2016 if they did not previously intend to report on a public health reporting measure, the alternate exclusions available for public health reporting in 2016, steps physicians have to take to determine if there is a specialized registry available, and the definition of a specialized registry.  Review these FAQs to learn more:

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OCR Updates Guidance on Fees for Patient Access to Health Records

The U.S. Department of Health and Human Services Office for Civil Rights (OCR) has updated its guidance on patients’ access to their health information under the Health Insurance Portability and Accountability Act (HIPAA). The guidance now includes a set of frequently asked questions addressing the fees that covered entities may charge patients for copies of their protected health information.  The AMA encourages physicians to review the new FAQs and update applicable policies and procedures to reflect this recent guidance.

HIPAA’s Privacy Rule generally requires covered entities to provide patients, upon request and in a format requested by the patient, with access to the health records the covered entity maintains about them in a designated record set.  Physicians can find additional information about HIPAA’s privacy and security requirements in the AMA’s HIPAA toolkit.
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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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Job Openings

DIRECTOR OF HEALTH SERVICES

The Director of Health Services provides leadership for Bowdoin College’s Health Center and is responsible for the daily operation and oversight of the medical staff and services of the Center. In addition to functioning as a key department head within the division of Student Affairs, s/he will serve as a licensed practitioner providing clinical services. The Director is a visible leader within the Bowdoin community, representing a trusted voice in student health matters, and educating the community about all types of health issues, including the integration of public health issues and the integration of mental health care. S/he must also have a keen appreciation for the varied health needs of a diverse student body. The Director balances administrative duties including oversight of the daily operations of the Center and clinical duties including providing primary and acute care to Bowdoin students and providing medical oversight of the clinical staff.

For further details about the position, job requirements, and to apply, please go to our careers website: http://careers.bowdoin.edu/postings/2783.

Bowdoin College is committed to diversity, inclusion and equality, and is an equal opportunity employer. We encourage inquiries from candidates who will enrich and contribute to the cultural and ethnic diversity of our College. Bowdoin College does not discriminate on the basis of age, race, creed, color, religion, marital status, gender identity and/or expression, sexual orientation, veteran status, national origin, or disability status in employment, or in our education programs.

4/4/16

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

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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