April 4, 2016

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POLITICAL PULSE: HHS Committee Scheduled to Review Amendment Language on L.D. 1646, Opioid Prescribing, and Others Today!

On Wednesday, March 23rd, the Legislature's Health & Human Services Committee 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.  Today, April 4th, the Health & Human Services Committee will be reviewing the final language of amendments to the bill.  Following this review the bill will be sent to the House and Senate for floor votes.  The127th Maine Legislature is scheduled to adjourn its Second Regular Session by April 20th.

Among the amendments is a proposal to delay the effective date of the limit on the average daily dose (100mg morphine equivalent dosage) for those patients who already exceed that dosage. The effective date of that limit would be 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 March 23rd, 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 www.mainemed.com.  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.  This provision will be effective January 1, 2017.  And HHS will have an opportunity to make improvements to the PMP prior to the effective date.

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.

The legislature's Joint Standing Committees are scrambling to finish up work on their final bills to get them out into action on the floor of the House and Senate.  During its work session this afternoon, the HHS Committee will be reviewing language on a number of bills previously voted, including L.D. 1646 described above, and also will review the fiscal note on the ACA Medicaid expansion bill, L.D. 633, which was released last Friday.  Today's House calendar includes the Governor's veto message on L.D. 1650, An Act to Enact the Recommendations of the Study of the Allocations of the Fund for a Healthy Maine.  Several bills of interest to the MMA, including L.D. 1305 on "shopping" for health care services, are tabled on the Senate calendar. 




Nation's Leaders Call for End to Stigma, Increased Access to Treatment

On March 29th, President Obama called for increased funding for treatment of substance use disorders, speaking to the leading voices in the effort to end the nation's opioid epidemic gathered in Atlanta at the National Rx Drug Abuse and Heroin Summit.  "This crisis needs all hands on deck," President Obama said.  "We have to think of this in a public health model."

“Concentrating on physician education [and] making sure that medication-assisted treatment programs are more widely available” are two important factors, he said.  “There are steps that can be taken that will help people battle through addiction and get onto the other side, and right now, that’s under-resourced.”

The conference, which brings together nearly 2,000 policymakers, health care professionals, patient advocates, law enforcement officials and others, has become the leading national venue to bring attention to the work being done to end the nation's opioid epidemic.

In one of the conference's "vision sessions," AMA Chair-elect Patrice A. Harris, MD, called on all states to work with physicians to not only enact meaningful policies to end the national crisis "but to implement those policies to have a meaningful impact."

In her speech, Dr. Harris detailed the five key recommendations of the AMA Task Force to Reduce Opioid Abuse. "We will know that we have succeeded when we prevent new cases,”  Dr. Harris said, “when a new generation of our loved ones no longer die from overdose, and when we provide treatment to all those who need it."

Read an AMA news release for more details about Dr. Harris’ session.
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Next MMA Weekly Legislative Committee Conference Call is Tuesday, April 5th 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, April 5th 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 amaclean@mainemed.com or 622-3374, ext. 214.

There are no new bills for review on this conference call.  We will discuss the status of key bills on opioid prescribing (LD 1646), certified professional midwives licensing (LD 690), alternative medical liability system (LD 1311), and shopping for medical services (LD 1305), along with the anticipated end-of-session schedule.


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Jessa Barnard, J.D. Named Vice President for Public Policy at Vermont Medical Society

MMA was pleased to learn recently of the appointment of Jessa Barnard, J.D. as Vice President of Public Policy for the Vermont Medical Society.  Jessa served as Associate General Counsel at MMA until mid-2014 and staffed the Public Health Committee.  In 2014, she re-located to her native state of Vermont when her husband Justin took a position with a law firm in Burlington.  While we were very sorry to lose Jessa, we are thrilled to have her continue her work in organized medicine in her home state.  Her father, Robert Block, M.D., an orthopedic surgeon in Bennington, is a past President of the Vermont Medical Society and currently serves as alternate AMA delegate for the VMS.   

Jessa had previously worked in the public health area for VMS following graduation from Dartmouth College and prior to her matriculating at Stanford Law School.  We wish her all the best as she re-joins the Vermont Medical Society.   She and her husband Justin reside in Montpelier with son Skyler and daughter Phoebe.

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Maine Opiate Collaborative Community Forums in 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.

  • 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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“Groundbreaking Effort” to Prevent Diabetes Announced

The U.S. Department of Health and Human Services (HHS) Wednesday announced it will soon begin covering diabetes prevention programs for Medicare beneficiaries as the result of a successful demonstration project.  It is the first time a preventive service model from the Center for Medicare and Medicaid Innovation (CMMI) has been expanded into the Medicare program, and the agency said the model holds promise for employers, private insurers and patients.

Success in preventing type 2 diabetes
The announcement highlights the success of a three-year demonstration project, funded by CMMI, that allowed the YMCA of the USA to deliver its Diabetes Prevention Program through local YMCAs to nearly 8,000 Medicare beneficiaries at a high risk of developing type 2 diabetes at no cost.

As part of its Improving Health Outcomes initiative, the AMA teamed up with the Y-USA and 26 physician practice pilot sites in eight states to develop tools and resources to increase physician screening, testing and referral for prediabetes.

The practices referred their patients with prediabetes to diabetes prevention programs offered by local YMCAs. Medicare beneficiaries were able to participate in this program at no cost as a result of the award from the Center for Medicare and Medicaid Innovation.

The Y-USA’s Diabetes Prevention Program is modeled after the Centers for Disease Control and Prevention (CDC) National Diabetes Prevention Program (DPP), which is a proven, evidence-based lifestyle change program. This 12-month lifestyle behavior intervention program helps patients adopt and maintain healthy lifestyles by eating healthier, increasing physical activity and losing a modest amount of weight in order to reduce their chances of developing the disease.

At a time when more than 11 million seniors have diabetes and another 26 million seniors (about one-half of all Americans over the age of 65) have prediabetes, the results of the demonstration project speak for themselves:

  • The estimated savings for Medicare per enrollee in the diabetes prevention program was $2,650 over a 15-month period, according to the HHS Office of the Actuary.  The savings more than recoups the cost of participating in the program.
  • Patients who enrolled in the diabetes prevention program lost about 5 percent of their body weight, which is enough to substantially reduce the risk of developing type 2 diabetes.
  • More than 80 percent of participants attended at least four weekly sessions.

Research by the National Institutes of Health has shown that diabetes prevention programs can reduce the incidence of new cases of type 2 diabetes by 58 percent.  The reduction in incidence increases to 71 percent for adults over the age of 60.

“This program has been shown to reduce health care costs and help prevent diabetes, and is one that Medicare, employers and private insurers can use to help 86 million Americans live healthier,” HHS Secretary Sylvia M. Burwell said in a news release.  “The Affordable Care Act gave Medicare the tools to support this groundbreaking effort and to expand this program more broadly.  Today’s announcement is a milestone for prevention and America’s health.”

A time for action
A study released in 2014 that used methods similar to those of the Congressional Budget Office estimated that Medicare coverage of diabetes prevention programs would reduce federal spending by $1.3 billion over a 10-year budget window.  The research was conducted by Avalere Health and released by the American Diabetes Association, the Y-USA and the AMA.

The study estimated that the cumulative rate of diabetes in the Medicare population would be reduced by an estimated 37 percent after a decade, resulting in nearly 1 million fewer cases of diabetes among seniors.

Risk of developing type 2 diabetes extends to a major portion of the U.S. population beyond Medicare beneficiaries. More than 86 million adults currently are living with prediabetes, but only 10 percent of them know that they have prediabetes and are at risk of developing type 2 diabetes.

“Today’s announcement signifies an important step toward ensuring all Americans at risk for type 2 diabetes have access to the resources they need to prevent this debilitating disease,” AMA President-Elect Andrew Gurman, MD, said in a statement Wednesday.  “Research shows that up to one-third of these individuals will develop type 2 diabetes within five years unless they lose weight through healthy eating and increased physical activity.”

The AMA sent a letter to the Centers for Medicare & Medicaid Services last month, calling for coverage of prediabetes screening, referrals to diabetes prevention programs and participation in diabetes prevention programs.  These services recently received a Grade B from the U.S. Preventive Services Task Force.

Under the Affordable Care Act, private health plans participating in the health insurance marketplaces and the Medicaid program are required to cover preventive services that are recommended with a grade of A or B by the task force.

For patients who have insurance through private plans, the AMA is encouraging employers and health insurance companies to cover participation in diabetes prevention programs as well.  The entities can use the AMA’s diabetes prevention cost-savings calculator to better understand how why they should offer this coverage, including the potential benefits for improving health outcomes while reducing health care costs.

Read more at AMA Wire®.

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Attention: Important Survey Opportunity to Inform a "State of the Union" of the Medical Profession

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

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 visitwww.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]

The Hanley Center Announces Additional Health Equity and Cultural Competence Trainings

Positive health outcomes are not evenly distributed across the public.  Some populations face much greater challenges in achieving and maintaining good health.  Public Health Leaders can play a crucial role in understanding the reasons for these differences and leading strategies to promote greater health equity.  In this workshop, we will explore the concepts of health and healthcare disparities, build greater insight into unconscious/implicit bias, and delve into models for developing individual and organizational cultural competence.

Below are links to the EventBrite pages with additional information and tickets:

Ellsworth Training – May 16th

Augusta Training – May 17th

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MaineCare Rate Study and Amended Rule for So-called "Section 17" Services Subject of HHS Committee Hearing

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.  The HHS Committee held a public hearing on the matter on Friday, April 1st.  The hearing began at 1 p.m. and continued almost to 9 p.m.  A work session is not yet scheduled, but is likely this week.

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 May 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 recently 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.  However, to date, HHS has not been willing to put into writing the assurances made to Senator Brakey.  Therefore, legislation may be required to ensure that the significant reductions in rates not go into effect prior to the legislature reviewing the proposed rates.





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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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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: 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.


INTERNAL MEDICINE PHYSICIAN - Maine Medical Partners Internal Medical Clinic

Maine Medical Partners is seeking a PT BC/BE internal medicine physician for their Internal Medicine Outpatient Clinic at Maine Medical Center in Portland, Maine. 

The Clinic is the primary outpatient teaching site for Maine Medical Center’s Internal Medicine Residency Program and is the medical home for a culturally diverse population.  The ideal candidate will have an interest in residency education and international/immigrant patient care.  The clinical portion of the position involves a mix of direct patient care and the precepting of Internal Medicine Residents. 

Maine Medical Center has 637 licensed beds and is the state’s leading tertiary care hospital, with a full complement of residencies and fellowships and an integral part of Tufts University Medical School. 

For more information please contact Alison C. Nathanson, Director, MaineHealth Physician Recruitment Center at (207) 396-8683 or nathaa@mainehealth.org.



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.



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.



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.


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, (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. 



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



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 mlefay@kvhc.org or visit our website at www.kvhc.org.  KVHC is an equal opportunity employer.


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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: http://www.eventbrite.com/e/health-benefits-laws-compliance-assistance-seminar-in-bangor-me-registration-22290052146

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 wardlaw.yasmin@dol.gov or (202)693-8615.

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