March 28, 2016

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POLITICAL PULSE: Opioid Prescribing Limits Further Amended and Approved by HHS Committee

On Wednesday, March 23rd, the Legislature's Health & Human Services Committee again worked on L.D. 1646, the Governor's bill limiting opioid prescriptions and requiring mandatory checks of the Prescription Monitoring Program (PMP), among other things.  Committee members expressed particular concern for the more than 16,000 patients currently exceeding the 100 morphine milligram equivalent (MME) and amended the proposal by allowing these "legacy" patients to receive current dosages up to a cap of 300 MME until July 1, 2017.  

The additional time is beneficial to the so-called "legacy" patients in two ways.  First, it provides them and their physicians a longer opportunity to taper from the higher dosages in cases where it is medically appropriate to do so.  Secondly, it provides time for DHHS to complete its rule-making which is expected to provide more exceptions to the law.  Currently, the exceptions included are for cancer pain, hospice care, palliative care, and for medication administered within a hospital or other facility.  The proposal also does not limit dosages for treatment of addiction.  But, in exchange for the additional time for the "legacy" patients to adjust to the potential law, patients receiving  new prescriptions for opioids for pain will now be subject to the potential law 90 days after the adjournment of the session.  That effective date is expected to be around the middle of July.  However, and very importantly, this limit can be overridden based on medical necessity documented by the prescriber until such time as DHHS has completed its rule-making.

One of the last actions taken by the Committee was to move some of the provisions of L.D. 1648, the bill prepared by MMA for Senator Roger Katz (R-Kennebec) into the Governor's bill and to then vote "Ought Not to Pass" on the Katz bill.  The substantive provisions moved into the Governor's bill include the requirement that pharmacists register as data-requesters in the PMP, the similar provisions for veterinarians, and the ability of the PMP to exchange data with the Canadian provinces.  

At the completion of the work session on Wednesday, the members of the HHS Committee voted 11 to 1 "Ought to Pass as Amended" on the bill.  Only Senate Chair Eric Brakey voted against the bill stating that as a supporter of classic libertarian principles, he could not vote for a bill which inserted the government between a patient and hie or her physician.

 A memo to the HHS committee providing the details of the earlier agreement can be found on the MMA website at  These details were presented to the HHS Committee at a work session on Friday, March 18th.  As covered in a previous Maine Medicine Weekly Update, MMA EVP Gordon Smith presented testimony in support of the bills, although with many caveats.

Essential to the original agreement was the extension of the 3-day limit for acute pain and the 15-day limit for chronic pain proposed in the Governor's bill, L.D. 1646.  The agreement provides for a 7-day limit for acute pain and a 30-day limit for chronic pain.  The seven day limit will mirror the law passed in MA last week.  These limits will apply only to opioid based medication prescribed for pain, not for medication prescribed for addiction treatment. In addition, exceptions are being developed for cancer pain, end of life care, hospice care, palliative care, and medication administered in hospitals and other institutional settings with additional exceptions to be developed through rule-making by DHHS.  The Department has agreed to accomplish the rule-making by January 1, 2017.

The mandatory education requirement in the Governor's bill will be changed to simply require that three hours of the existing 40 hours of category one CME credits be committed to the topic of prescribing for pain for those physicians who are prescribing opioid medication.  All the licensing boards regulating prescribers of controlled substances will be directed to amend their continuing education rules to implement this mandate.

The amended bill will continue to require a check of the Prescription Monitoring Program (PMP) each time a new opioid or benzodiazepine script is written and every 90 days thereafter if the scripts continue to be written.

The requirement to electronically transmit opioid scripts to a pharmacy is retained in the agreement with an effective date of July 1, 2017 but at the work session on March 23rd the Department agreed to allow those prescribers who are not able to meet the deadline to file a plan with the Department which could then grant a waiver.  Exceptions may be developed by rule similar to the process in New York State which is the only state currently with a firm mandate to transmit all prescriptions for controlled substances electronically consistent with the DEA technical requirements to ensure proper authentication of identification.

Several provisions in L.D. 1648 sponsored by Senator Roger Katz (R-Kennebec) received the support of the majority of the HHS committee and are going to be grafted on to the Governor's bill.  These provisions include some enhancements to the PMP and a requirement that pharmacists register to be data requesters, as prescribers are required to do.  Pharmacists will also be required to check the PMP under specific circumstances.   With the adjustments made to the bill, pharmacy interests have indicated support for the proposal.  Veterinarians with a DEA license will also be required to register to use the PMP and will be required to check the PMP if they write a prescription to be filled in a pharmacy.

These details will be discussed during the weekly legislative call at 8:00 pm Tuesday evening.  All MMA members are welcome to join the call (see the call details and call-in numbers in accompanying article).  Input from any member is still welcome as the bill will not be considered by the full legislature until April.

MMA believes that in the current political environment with substantial concern about the opioid abuse epidemic among Maine policymakers, legislation in keeping with the agreement described in this article and the memo mentioned above is almost certainly going to pass this session.  MMA recognizes that members will have varying views on the elements of this agreement and we encourage you to communicate your views on the legislation to your own Representative and Senator and, if you don't know your members, you can find each and their contact information here.

Questions about the agreement or communicating with legislators should be directed to any of MMA's advocacy team of Gordon Smith, Esq., Andrew MacLean, Esq., and Peter Michaud, J.D., R.N.  They can be reached by calling the office at 622-3374.



MaineCare Rate Study for Mental Health Services Leads to Proposals with Devastating Impact

Mental Health agencies in the state and their health professionals are gearing up for a difficult fight over rate cuts proposed by DHHS based upon the results of a rate study for behavioral health and targeted case management services authorized in the state budget document passed last June.  The study was conducted by Burns & Associates out of Phoenix, Arizona.

Dated March 14, 2016, the study proposes some severe cuts to reimbursement for certain mental health services, including medical management, a service primarily performed by psychiatrists.  The Maine Association of Psychiatric Physicians (MAPP) is urging its members to communicate both with MaineCare officials and key legislators emphasizing the devastating impact that these reductions would have on the patients currently receiving these services and the impact as well on patients needing these critical services in the future.  

DHHS Commissioner Mary Mayhew is quoted in the media as stating that the rate study is part of an effort to make sure taxpayer-funded services cost what they should.  She told the Bangor Daily News, "This isn't a rate reduction tied to some budget cut that's got to happen because some budget has been reduced.  This is about what are the wages you pay staff, what is the overhead you pay for rent or other overhead costs that support the operation of the agency and what, therefore, is an appropriate cost." 

The rate study was added to the budget document as part of budget negotiations last year when the LePage Administration proposed to cut millions of dollars in MaineCare reimbursement for children's mental health services.  The budget document called for studies in two particular areas, Section 28, which includes services for children with cognitive impairments and Section 65, which includes behavioral health services.  The Department later added Sections 13 and 17 to the study.  Section 13 covers case management services and Section 17 covers community support services for adults with severe mental illness.

Interested parties have until April 8th to comment on the proposals which will then go to formal rule-making later in the year.   The proposals were subject to an information session before the HHS Committee of the legislature last Tuesday, March 22nd.   Concern was expressed by a number of clients and the Democrats on the Committee have expressed a need to slow the proposals done and have a legislative review.   Senator Tom Saviello, (R-Franklin) has prepared an after-deadline bill asking for a delay in implementation of any of the reductions in reimbursement until such time as they are reviewed by the Legislature.  The bill has not yet been considered for late introduction into the session.  At a meeting today between Senate HHS Chair Eric Brakey (R-Androscoggin) and MaineCare officials, a revised timeline for the effective date of any implementation was presented which may eliminate the need for the Saviello legislation.  It is hoped to have the results of that meeting confirmed in writing within the next day or so.  In the meantime, an appropriate strategy for those opposing the reductions is to communicate with their State Senator as the House leaders have already indicated support for the bill.





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Next MMA Weekly Legislative Committee Conference Call is Tuesday, March 29th 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 29th 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:  1-605-475-6711 (NOTE NEW NUMBER!)

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 or 622-3374, ext. 214.

There are no new bills for review on this conference call.  We will continue the discussion of the opioid bill (L.D. 1646) and discuss the status of the proposal by Sen. Thomas Saviello (R-Franklin) to have a legislative review of the proposed MaineCare rate reductions for a number of specified mental health services, including medical management.


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MMA Presents Program on Addressing Suicide Risk

The MMA is presenting a free educational program entitled, Addressing Suicide Risk in Healthcare Settings:  Assessment, Management, and Follow-Up on Friday, April 1st from 9:00 a.m. to noon at the MMA office in Manchester.  The faculty will be Greg Marley, LCSW, Clinical Director of NAMI Maine.  The content of the seminar will include:

  • Trends in suicide in Maine and the U.S.
  • Application of Zero Suicide Initiative to Maine organizations
  • Recognition of increased risk of suicide in specific populations
  • The risk assessment interview process and content
  • Assessment using the C-SSRS tools
  • Suicide management using safety planning and assured follow-up
  • Suicide Survivor needs, including clinicians as survivors

Registration materials are posted on the MMA website [return to top]

Maine Opiate Collaborative Community Forums in Ellsworth, Bangor, Lewiston, Portland, Biddeford, and Waterboro

The Community Forums presented by the Maine Opiate Collaborative continue with public forums upcoming in the following communities.   Physicians are encouraged to attend.

  • March 28:   Ellsworth, 6-8 pm;
  • March 30:   Bangor, Room 124, Eastport Hall, University of Maine, 128 Texas Avenue, 6-8 pm;
  • March 31:   Lewiston, Lewiston Middle School, 75 Central Avenue, 6-8 pm;
  • April 6:       Portland, Ocean Gateway, 14 Ocean Gateway Pier, 6-8 pm;
  • April 8:       Biddeford, Alfond Forum, 630 Pool Street, UNE, 6-8 pm;
  • April 14:     East Waterboro, Fire Station, 6 John Smith Road, 6-8 pm;
  • April 20:     Mexico, Mountain Valley Middle School, 58 Highland Terrace, 6-8 pm.

These forums are supported financially by the Maine Medical Education Trust with grant funds provided by the Maine Health Access Foundation and the Maine Community Foundation.  More details can be found on the website of the U.S. Attorney for Maine.

The forums are all facilitated professionally by Carol Kelly of Pivot Point, Inc.  In addition to receiving comments from the public, the forums include a panel discussion with presenters from local law enforcement, health professionals, addiction treatment specialists, public health representatives, and persons in recovery.

The Maine Opiate Collaborative was established last fall by U.S. Attorney Thomas Delahanty, Attorney General Janet Mills, and Commissioner of Public Safety John Morris.  




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Update on SIM Steering Committee

The following report of the March 23rd meeting was prepared by Rhonda Selvin, APRN and is forwarded to MMA members on behalf of herself and Noah Nesin, M.D., FAAFP.   Rhonda and Noah represent health care professionals on the SIM (State Innovation Model) Steering Committee.  We are very grateful for their willingness to attend the many meetings and regularly report on the status of the project.

The meeting was held at MaineGeneral Medical Center from 9:00 am to noon.

Minutes inadvertently not in the packet will be reviewed and accepted at the next meeting.  

A multi-payer Medicare Alignment payment model Primary Care proposal is currently in process, lead by the office of MaineCare Services (OMS).  The status of this proposal, designed to have Medicare participate in alternative payment models, was reviewed.  A draft proposal is being written by a subgroup and will be reviewed by the Committee and stakeholder groups.  A facilitator will be enlisted to help with development.  MMA representatives have been invited to participate in the initial meeting of the Oversight Committee next week and we hope to have practicing physicians on the Committee, as well. 

SIM Refocused Approach Overview:  A graphic presentation was included in the documents forwarded to committee members.  The overview identifies broad to specific goals and the timeline moving forward.  A small number of patients at participating sites is identified as a problem.  Dr. Yoe will return to the next meeting with the data.  Practices that are identified by Medicaid claims data as low performers and those as bright spots will be identified and best practices shared.  Governance group will be asked to stay in place for another year.

Update from the SIM funded CDC program Diabetes Prevention Program (NDPP) from Deborah Wigand and Nate Morse.  They have met with leadership but not with the health plans directly but will seek to do so.  They have looked to other CMMI-SIM states for alignment.  The state employers have moved this into their benefit plan.  BIW still links it with their wellness program.  Value-based Insurance Design (VBID) can add this to their work plan and will invite Nate to present at a future meeting.  Penny is present from Cianbro which has a strong wellness focus with CIGNA as their carrier, but this is not currently at the benefit level.  Going forward, it may be best to build this into benefits so that the program has some sustainability.

SIM evaluation updates rescheduled to review the definition and the goal of the Fragmented Care Index (FCI). How we can understand the goals of reducing fragmentation and the patient care experience.  All agree that decreasing fragmented care is a goal but we need to understand how that is defined.  The idea of an expanded dashboard including patient experience could be used to improve care.  Care coordination must be addressed, long term care still has a great need for primary care providers, many of their patients are not covered for primary care and even more so for behavioral health.  They use some telehealth but the need remains high to prevent gaps in care.

Jay Yoe reviewed the patient surveys both qualitatively and quantitatively.  The goal now is to narrow the focus rather than broad studies at this point.  The commercial plans have decided that they will not endorse specific targets for SIM at this pilot stage.

Steering Subcommittee Reports:

Frank Johnson for Maine Health Management Coalition.  Work group will focus on data that can be extracted without additional work for providers or practices.  Health systems have been invited to weigh in around data and metrics first with the commercial population and patient experience from surveys.  

Lisa Tuttle for Quality Counts.  Delivery System Reform Subcommittee has had good participation and engagement.  Two key pieces of measures and new focus.  Last meetings, both Jay Roe and representatives of the Lewin group presented.  Care coordination may be a focus going forward but no particular goal has been established.  Payment reform still is a concern.  The subcommittee will prepare an update around the shared EHR for the next meeting.

Lisa Tuttle again for Quality Counts.  TCPI work in Maine, NNE-PTN summary and update. This is one of 29 contracts awarded across the country.  PTN's work directly with practices. There is also a group called SAN's, primarily professional associations that are to support the PTN's.  There are o payments to the practices but may offer additional transformation support to the practices around payment evolution at no cost, including support around PQRS.  This includes both primary care and specialty practices.  Practices that are part of a Medicare shared savings plan, Medicare ACO or PCMH are not currently eligible.

There was no public comment at this meeting.

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Maine AG's Office Offers Bidrigging Prevention Training

For those of you who may be involved in competitive bidding for government service agreements, the Maine Office of the Attorney General is providing a training opportunity to avoid problems in the contracting process.  The training is scheduled for April 14th at 10:00 a.m. at the Governor Hill Mansion in Augusta.  The training is expected to last about 90 minutes, depending on the level of audience engagement.

The training will show what to look for in detecting an antitrust violation: i.e., bid-rigging, price fixing, and market allocation. It will explain how these conspiracies are prosecuted and give tips on how to detect and prevent these schemes.  It will highlight common pitfalls and walk through what to do if you run into these red flags.

Bryan Serino is a Trial Attorney in the New York Office of the U.S. Department of Justice’s Antitrust Division.  At the Antitrust Division, he investigates and prosecutes criminal international and national conspiracies involving bid-rigging, price-fixing, and market allocation.  Prior to his time with the Department of Justice, he was an Assistant District Attorney at the Manhattan District Attorney’s office where he investigated complex frauds and international narcotics conspiracies.

The Governor Hill Mansion
136 State Street
Augusta, Maine 04330
Phone: (207) 629-4052

Conveniently located close to the Capital Building and Western Avenue in Augusta, we are only a mile off Exit 109 on I-95. The Governor Hill Mansion is at 136 State Street, on the corner of State and Green.

 If you are interested in attending this training, please contact Andrew MacLean, Deputy EVP & General Counsel, at or 622-3374, ext. 214.  While not asking for a commitment, the AG's Office has asked MMA to provide them with some indication of the level of interest in the program.


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2016 Value-Based Payment Modifier Results Announced

128 physician groups will be seeing payment increases of 15.9 percent or 31.84 percent per claim this year as a result of the value-based payment modifier (VBM).  The sizeable increases for these practices were financed by payment reductions of 1-2 percent for 5,477 other practices, many of which are appealing the cuts.  Claims adjustments will start March 14th, with retroactive adjustments for claims paid prior to that time.

The 2016 payment adjustments are based on cost and quality data from 2014, when 13,813 practices of 10 or more physicians and other practitioners were subject to the VBM.  Any practice that failed to participate successfully in the Physician Quality Reporting System (PQRS) was subject to an automatic 2 percent VBM penalty as well as a 2 percent PQRS penalty.  Those who met the PQRS reporting requirement then were subject to a “quality tiering” process in which their cost and quality scores were compared with other practices.  Those with the best cost/quality combination win payment bonuses, and those with the worst cost/quality score are subjected to payment penalties.

8,208—or 98 percent—of the 8,395 successful PQRS participants will see no change in payments as a result of the “quality tiering” process.  However, 59 participants will face 1 or 2 percent penalties because they “performed poorly,” while 128 others will see bonuses that are much larger than anticipated.

Due to a number of systemic reporting problems, many practices that have reported successfully in the past were judged as failing this year.  More than one-quarter of the practices subject to PQRS and/or VBM penalties this year are appealing that determination.

The AMA has repeatedly called on the Centers for Medicare & Medicaid Services (CMS) to improve the reporting process and has urged that all practices that attempted to report PQRS data be held harmless from penalties this year.  The AMA also will seek more detailed information needed to do pattern analysis and evaluate the impact of the VBM.


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AMA Responds to CMS Measure Development Plan

Under the Medicare Access and CHIP Reauthorization Act (MACRA, Section 102), the Centers for Medicare & Medicaid Services (CMS) was required to develop and post a draft plan on the development of quality measures related to the new Medicare Merit-Based Incentive Payment System (MIPS) and alternative payment models (APM).  In response, the AMA submitted comments calling on CMS and payers to re-think the design of quality programs for the MIPS and APMs.

The AMA urged CMS to take into consideration the varying specialties within medicine and to start viewing measures as a guide to address broad problems.  The AMA strongly encouraged CMS to improve upon the current quality programs and avoid adopting the one-size-fits all approach as currently constructed under the value-based modifier and meaningful use programs, which have diverted physician efforts and resources away from participating in activities that truly have a positive impact on patient care.

The final Measure Development Plan is required to be released by CMS by May 1st, followed by annual updates or as otherwise appropriate.  The AMA will continue to actively monitor and comment.  
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Upcoming Events

MCMI Training Programs – Level 1 and Level 2

General Information for 2016

When and where held:

              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


Health Benefits Laws Compliance Assistance Seminar

April 5-6, 2016, Bangor

The US Department of Labor and the Maine Bureau of Insurance are co-sponsoring a health benefits laws compliance assistance seminar in Bangor on April 5-6, 2016 at the Ramada Bangor (357 Odlin Road, Bangor, ME 04401).  We invite you to attend.

The goal of this free seminar is to bring interested parties helpful information, tips and clarification on Maine and federal laws, including information about the Employer Shared Responsibility requirements of the Affordable Care Act.  The attached agenda provides more information about the presentations.  You may attend as many presentations as your schedule allows. 

If you are interested in registering, please visit:

For more information, contact Ms. Yasmin Wardlaw, Health Benefits Education Campaign Coordinator, Office of Outreach, Education and Assistance, US Dept. of Labor/ Employee Benefits Security Administration, at or (202)693-8615.

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Job Openings


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:

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.



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 for an application. Completed cover letter, resume, and employment application will be accepted until position is filled.



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 or call (207) 406-7872, for more information.



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 or call (207) 406-7872, for more information.


Relocate to Beautiful Southwestern Maine - FAMILY PRACTICE PHYSICIAN

Sacopee Valley Health Center has a position available for a full-time family practice physician for our multi-service, progressive, rural federally qualified community health center located 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. Competitive salary and benefits package; physicians are eligible to apply for NHSC loan repayment.  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, (, Sacopee Valley Health Center, 70 Main Street, Porter, ME 04068. EOE. Sacopee Valley Health Center is an equal opportunity provider and employer. 



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



The Maine Highlands offers great outdoor adventures, historic and cultural experiences, many culinary delights and unexpected entertainment opportunities.  KVHC’s newest clinic, Brownville, is located in the Maine Highlands and Katahdin Region.  As a result of this 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 the Brownville/Millinocket Maine regions.   KVHC’s clinics are outpatient only 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 or visit our website at  KVHC is an equal opportunity employer.


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