May 2, 2016

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Maine Medicine Fares Well on Veto Day

Friday, April 29th, was “Veto Day” at the State House—the day the Legislature reconvened for the last day of the session to vote on the 33 vetoes submitted by Governor LePage.  All in all, it was a good day for medicine in Maine.  The Legislature sustained 12 vetoes and overrode 20, with one tax bill being allowed to die at adjournment after being sent back to committee.  Ten of the 20 veto overrides had at least passing reference to medical issues.

Of the 33 bills vetoed by Governor LePage, only one bill relating in any way to medicine was the subject of a sustained veto.  LD 867 would have had some limited effect on the tax on marijuana dispensaries.  The override vote failed by a significant margin in the House.

Of the 20 vetoes that were overridden, 10 related in some way to medical issues.  We will address them in legislative document (LD) numeric order.

LD 365 (now labeled Public Law chapter 503) calls for a tax reduction for home modifications for disabled persons. The Governor opposed it because it calls for expenditures from the General Fund.  He also said in his veto message that even if he did support such a bill, he disagrees with the income cap of $55,000.

LD 690 (PL chapter 502) provides for the licensing of midwives in Maine.  The Governor said that private associations can set standards for midwives without regulation by the state, and he is concerned that the bill calls for its implementation by the Department of Professional and Financial Regulation using existing resources rather than an appropriation by the Legislature.

LD 1465 (Resolve chapter 87) is a “Resolve” requiring the Department of Health and Human Services to commission a study of ambulance services in Maine.  The Governor objects to funding a study out of the DHHS budget, stating that if the Legislature wants such a study it should pay for it.

LD 1468 (Resolve chapter 86) requires state ferries to provide locked containers for the shipment of medical specimens from the islands to the mainland, and it calls for a review of the Maine State Ferry Service.  The Governor objects to the Legislature “tell[ing] a department in the Executive Branch how to do its job….”

LD 1498 (PL chapter 511) clarifies Medicaid ombudsman services for children under MaineCare.  The Governor said the bill was unnecessary as an “inoperable expansion of government” due to the funding mechanism, which forbids the use of State funds to achieve its purposes.  These purposes, the Governor stated, can be provided by a private organization without government involvement.

LD 1547 (PL chapter 508) allows the sale of Naloxone, an opioid overdose reversal medication, “behind the counter” but without a prescription.  This will allow both first responders and private citizens to purchase Naloxone. The Governor’s veto, he said, is based on his belief that the bill simply “Creat[es] a situation where an addict has a heroin needle in one hand and a shot of naloxone in the other produc[ing] a sense of normalcy and security around heroin use that serves only to perpetuate the cycle of addiction.”  He also said, “Naloxone does not truly save lives; it merely extends them until the next overdose.”

LD 1552 (PL chapter 507) establishes a hypodermic needle exchange program.   The Governor’s veto is based solely on the fact that the bill does not appropriate any money to fund its operation.

LD 1617 (PL chapter 506) appropriates money to fund two additional positions in the Long-Term Care Ombudsman program.  The Governor stated that these positions are “not necessary in a government of this size, which already has many employees and unfilled positions.”

LD 1645 (PL chapter 505) funds pay increases for direct care employees at Riverview Psychiatric Center, to help with recruiting efforts. The Governor stated, “The easiest thing the Legislature can do to help Riverview is to stop subjecting it to a constant barrage of hearings reports and studies.”  He said that the greatest barrier to recruitment is not the wage level but, rather, “the negative publicity [Riverview] receives in the media.”

LD 1696 (Resolve chapter 88) calls for a moratorium on rate cuts under chapters 13, 17, 28 and 65 of the MaineCare Benefits Manual until 2017.  The Governor stated that the bill is a “highly partisan measure” that allows one branch of government to “infringe on the powers of another.”

The MMA will soon be publishing a review of the entire two-year legislative session, focusing on those bills which affect medicine most significantly.

Governor Signs L.D. 1646 into Law Setting the Stage for a Change in the Culture of Prescribing for Pain

At a brief signing ceremony last Tuesday, Governor LePage signed L.D. 1646, An Act to Prevent Opiate Abuse by Strengthening the Controlled Substances Prescription Monitoring Program.  The provisions in the law have different effective dates with the first limitation taking effect 90 days after the session adjourns. That date is likely to be around August 1, 2016.  Other provisions take effect on Jan. 1, 2017 and July 1, 2017. 

The provision taking effect in August limits prescribing of an opioid medication to 100 morphine milligram equivalents (MME) per day.  But there are many exceptions, as follows:

1.  Until Jan. 1, 2017 (or on the effective date of the rules establishing exceptions, whichever is later), prescribers may prescribe in an amount greater that the limit as long as it is medically necessary and the need is documented in the patient's chart.  

2.  A patient who, on the effective date of the section, has an active prescription for opioid medication in excess of 100 MME per day may be prescribed an amount that would not exceed 300 MME (until Jan. 1, 2017).

In addition, there are general exceptions to the limits on daily dose and durational limits for the following:

1.  Pain associated with active and aftercare cancer treatment.

2.  Palliative care.

3.  End-of-life and hospice care.

4.  Medication-assisted treatment for substance use disorder.

5.  Other circumstances determined in rule by the Department of Health and Human Services.

Data in the prescription monitoring program indicate that there are currently more than 16,000 patients currently receiving opioid medication exceeding the 100 MME limit.  Many may be currently subject to an exception (such as cancer treatment) but the PMP does not include diagnosis information so the number of individuals who are exempt is not known.  Patients not currently exempt through one of the exceptions above and who are not able to be tapered to an amount no greater than 100 MME will have until July 1, 2017 to be put into another exception through rule-making.

The second phase of the law begins Jan. 1, 2017 and includes limits on the duration of a script for an opioid medication. The scripts can be renewed but again for a limited time.  For acute pain, the limits in a 7 day period is a 7 day supply. In other words, a patient can receive an initial script for a 7 day supply and the patient can not receive another script until the 8th day, again limited to a 7 day supply.  For chronic pain, the limit is 30 days, again renewable.  Prescribers may wish to add "for acute pain" or "for chronic pain" on the script so that a pharmacist will be aware.

The durational limit effective Jan. 1, 2017 follows enactment of a similar provision in Massachusetts which also limits scripts for acute pain to 7 days.

The limits on the scripts are also subject to all the exceptions noted above.

Also on January 1, 2017, the section of the law requiring checks of the Prescription Monitoring Program (PMP) takes effect.  A prescriber must check the PMP upon initial prescription for a benzodiazepine or an opioid medication and every 90 days for as long as that prescription is renewed.  Pharmacists also must check the PMP under certain circumstances.  There is an exception in settings such as hospitals (inpatient) emergency rooms, and long-term care facilities when the medication is directly ordered or administered in the setting.

Next, by July 1, 2017 all opioid scripts must be prescribed electronically.  A prescriber who does not have the capability to electronically prescribe must request a waiver from this requirement from the Commissioner of Health and Human Services stating the reasons for the lack of capability, the availability of broadband infrastructure and a plan for developing the ability to electronically prescribe opioid medication.

On Dec. 31, 2017, the final piece of the law kicks in.  By that date, all the categories of licensed health professionals who wish to continue to prescribe opioid must have completed 3 hours of continuing education every 2 years on the topic of prescribing of opioid medication.

Section 37 of the law is entitled Enhancements to the Controlled Substances Prescription Monitoring Program.  It requires HHS to include in its current RFP a series of enhancements to the PMP, including the establishment of a mechanism or calculator for converting dosages to and from morphine milligram equivalents and a mechanism to automatically transmit de-identified peer data on an annual basis to prescribers of opioid medication.  These enhancements are seen as particularly helpful to prescribers.  While there is a financial penalty that can be assessed ($250 per violation capped at $5,000 annually), Section 37 language delays any enforcement of the limits on opiod prescribing in the law until the enhancements to the PMP are implemented.

A copy of the law can be found on the MMA website at (in the spotlight section on the home page).  You also will find a PowerPoint overview of the new law posted on the web site.  MMA attorneys are available to answer questions and to do presentations about the law.  Call Gordon Smith, Esq., MMA's EVP at 622-3374, ext. 212 if your practice or medical staff would like to take advantage of this opportunity (or send e-mail request to

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MMA's Annual HIPAA Update on May 6th Features Attorneys Ken Lehman, Lori Dwyer, and Ben Townsend; Moderated by MMA's Peter Michaud, J.D., R.N.

One of MMA's most popular CME programs, our Annual Health Information Privacy Compliance Seminar ("HIPAA Update"), is scheduled for Friday, May 6th at the MMA headquarters in Manchester.  The program also will be available by webinar.  Registration and breakfast will begin at 8:30 a.m. and the program will run from 9:00 a.m. to noon.  The presenters for the program are:

  •  Peter Michaud, J.D., R.N., MMA Associate General Counsel;
  • Kenneth Lehman, Esq., shareholder and Chair of the Health Care Group at Bernstein Shur, Portland;
  • Lori Dwyer, J.D.,  General Counsel and Compliance & Risk Officer, Penobscot Community Health Care, Bangor; and
  • Benjamin Townsend, Esq., shareholder at Kozak & Gayer, P.A., Augusta.

Registration materials will be posted on the MMA web site,, very shortly.  For more information, please contact Sarah Lepoff at or 622-3374, ext. 213. [return to top]

Historic Medicare Payment Policy Changes an Opportunity for Success

Medicare Access and CHIP Reauthorization Act (MACRA) proposed rules issued last week by the Centers of Medicare & Medicaid Services (CMS) represent the most sweeping change in physician payment policy in the last 25 years.

The proposed regulations
"Our initial review suggests that CMS has been listening to physicians' concerns,” AMA President Steven J. Stack said in a statement Wednesday.  “In particular, it appears that CMS has made significant improvements by recasting the electronic health record (EHR) meaningful use program and by reducing quality reporting burdens.”

Among the questions the 962-page proposed rule addresses are:

  • Quality:  In this category, clinicians would choose to report six measures, rather than the current requirement of nine measures, from among a range of options that accommodate differences among specialties and practice settings.
  • Advancing care information:  For this category, clinicians would choose to report customizable measures that reflect how they use technology in their day-to-day practice.  Unlike the existing EHR meaningful use program, this category would not require all-or-nothing EHR measurement or redundant quality reporting.
  • Clinical practice improvement activities:  This category would reward physicians for clinical practice improvements, such as activities focused on care coordination, patient engagement and patient safety. Clinicians would select activities that match their practices’ goals from a list of more than 90 options.

Providing physician feedback
“We are at the beginning of the formal rulemaking process,” Dr. Stack said in an AMA Viewpoints Wednesday. “CMS leadership has asked for feedback on what the agency did well in the proposed rule, what needs to be revised and what else needs to be included.”

“This proposed rule gives us an opportunity to provide thoughtful feedback to CMS in order to secure further improvements in the final regulations,” Dr. Stack said.

The AMA will develop a detailed analysis of the proposed rule and coordinate formal written comments with state and national medical societies in the coming weeks.

Keys to successful implementation
Barbara McAneny, MD, immediate past-chair of the AMA Board of Trustees, was among four physician leaders who testified last week at a hearing of the U.S. House Energy and Commerce Committee’s Subcommittee on Health.  Dr. McAneny pointed to three aspects of implementation that CMS will need to pay careful attention to as it works on regulations coming out of MACRA:

  • Consolidating performance reporting.  Specifically, the new regulations will need to move away from a pass-fail program design to accommodate the needs of all practices, specialties and patient populations. CMS also will need to improve the timing of feedback reports for physicians.   And the agency must minimize unnecessary data collection and the reporting burden.

  • Broadening APMs.  “MACRA regulations must establish a clear pathway for rapid approval and implementation of physician-focused APMs that establish different approaches to delivering patient care,” Dr. McAneny said.

    “CMS must avoid adding unnecessary and burdensome requirements to APMs that cause resources to be spent on administrative costs rather than helping patients,” she said.  Instead, the agency should provide data and assistance to identify models that are relevant for their practices.

  • Improving measurement.  Dr. McAneny pointed to such needed improvements as suitable methods for attribution and resource use, elimination of the program flaws that make practices with high-risk patients more susceptible to penalties, and timely data reports.

Helping physicians succeed
To help physicians succeed under the new Medicare system, the AMA will be offering step-by-step guidance and practical resources for practices that will pursue participation in APMs or MIPS.  Resources currently available include an expert-authored guide to physician-focused payment models, key points of MIPS and five things you can do now to prepare.

The AMA’s STEPS Forward™ collection of practice improvement strategies also offers a variety of education modules to help physicians take steps toward advancing team-based care, implementing electronic health records, improving care and practicing value-based care.

A physician expert will be the featured speaker for a webinar at 2 p.m. Eastern time May 11, during which she will share how her practice has adopted a value-based care model that has let them focus on keeping patients at the center of care. Register to participate.

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CMS Announces “Largest-ever Initiative” to Improve Delivery of and Payment for Healthcare

On April 11th the Centers for Medicare and Medicaid Services unveiled the Comprehensive Primary Care Plus ("CPC+") model, a nationwide medical home model for primary care that will establish regionally based multi-payer payment reform and changes in care delivery. The model will be implemented in up to 20 regions and cover more than 20,000 physicians and clinicians and around 25 million patients. It promises to let doctors care for their patients the way they think will work best and to reward them for achieving results and improving care. An ambitious five-year plan, the CPC+ is intended to help primary care providers:

  • ·        Help patients with serious or chronic diseases achieve their health goals;
  • ·        Give patients 24-hour access to care and health information;
  • ·        Deliver preventive care;
  • ·        Engage patients and their families in their own care; and
  • ·        Work with hospitals and other clinicians, including specialists, to provide better coordinated care.

Primary care practices will be required to give patients around-the-clock access to care and health information, and they will be required to meet various requirements for managing and coordinating care.  The plan is designed to move away from dependence on following certain treatment protocols or administering particular tests. The hope is that the new plan will encourage more communication between doctor and patient and an increased use of telehealth techniques.

There will be two tracks in the program, one similar to the existing CPC and designed for practices “ready to build the capabilities to deliver comprehensive primary care,” and the other for practices “poised to increase the comprehensiveness of care through enhanced Health IT, improve care of patients with complex needs, and inventory of resources and supports to meet patients’ psychosocial needs.”  Track One will continue with a form of fee-for-service payment, while Track Two will move to “Comprehensive Primary Care Payments", a combination of Medicare fee-for-service and a percentage of the practice's expected Evaluation and Management reimbursements.  Both tracks will receive up-front incentive payments.

CMS will first invite selected practices to participate in regions where there is sufficient interest from multiple payers, responding to proposals filed from now through June 12, 2016.  Then it will publicize the regions involved and accept applications beginning July 15, 2016 from practices within those regions.

A set of frequently asked questions is available from CMS here.  Also available are a Press Release and a Fact Sheet.

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CMS Open Payments Review & Dispute Period Begins

The Centers for Medicare & Medicaid Services (CMS) announced the beginning of the 45-day Sunshine Act, also known as “Open Payments,” review and dispute period.  After the review and dispute period concludes May 15, CMS will publish the 2015 payment data and updates to the 2013 and 2014 data June 30.

Physicians planning to review their 2015 Open Payments data should test their CMS Enterprise Portal (EIDM) logon credentials beforehand.  Troubleshoot locked accounts and other logon issues by visiting frequently asked questions for EIDM Users.

Physicians can refer to the AMA website or CMS guidance for step-by-step instructions on how to register to review and dispute data.  For answers to additional questions, email Medicare’s Open Payment Help Desk, or call (855) 326-8366. [return to top]

2016 PQRS Group Practice Reporting Option Open Until June 30th

Practices consisting of two or more eligible professionals that would like to participate in the 2016 Physician Quality Reporting System (PQRS) under the group practice reporting option (GPRO) have until 11:59 p.m. Eastern time June 30, to register as a GPRO.

Practices with two or more eligible professionals do not have to participate in PQRS as a GPRO and may participate as individuals in the program. This may be a better option for certain practices.

Upon GPRO registration, a practice must indicate whether they plan to participate in PQRS under the following options:

  • Qualified PQRS registry

  • Qualified clinical data registry—new 2016 GPRO option

  • Electronic health record (EHR)

  • Web interface—for groups with 25 or more eligible professionals only

  • Consumer Assessment of Health Providers and Systems (CAHPS) for PQRS Survey through a Centers for Medicare & Medicaid Services (CMS) certified survey vendor (as a supplement to another GPRO reporting mechanism). A GPRO with a 100 or more eligible professionals must report CAHPS. See CAHPS for PQRS Made Simple for complete details.

If a practice would like to participate as a GPRO and submit data via electronic health record (EHR), it is highly recommended that the practice consult their EHR vendor before registration. Some EHR vendors will not support the GPRO EHR option, only the individual PQRS EHR option.  Qualified clinical data registry participants also should check with their vendor to determine if they will support the GPRO option.

The AMA recommends that a practice weigh all options before signing up for GPRO in 2016, because a practice cannot change its GPRO designation with CMS once the registration period closes.  If a physician is participating in PQRS as an individual, there is no need to register.

The registration system can be accessed using a valid Enterprise Identity Management (EIDM) account. Instructions for obtaining an EIDM account with the correct role are provided on the PQRS GPRO registration Web page. Instructions for registering to participate in the 2016 PQRS GPRO are provided in the 2016 PQRS GPRO registration guide.
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New Lancet Study Questions Warnings on Anti-Smoking Drugs

A new study requested by the U.S. FDA and published recently in The Lancet suggests that the anti-smoking drugs Chantix (varenicline) and Wellbutrin or Zyban (bupropion) may not increase risk of suicide and other mental health disorders. Study results show that such issues arise during smoking cessation independently of any medications being used.

Addiction specialist Laurie Zawertailo, quoted in the newsletter HealthDay, stated that smoking cessation itself can be accompanied by severe mood changes. “Clinicians should monitor all of their patients, especially those with a current or past psychiatric illness, for these changes.”

As a result of the study, companies marketing these drugs hope the FDA will allow them to remove current “black box warnings” which were based on anecdotal patient reports of psychiatric events during drug-assisted smoking cessation. The Associated Press reports that the study may also prompt the Federal Aviation Administration to reconsider its ban against pilots and air traffic controllers using Chantix.

The FDA says it will review the study and other scientific evidence and “take follow-up action and update the public as appropriate.”

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April/May/June Issue of Maine Medicine Online Now

The April/May/June issue of the Maine Medicine newsletter can be read online now!  If you prefer to read a hardcopy, it will be arriving in your mail this week.  We welcome your feedback, feel free to email [return to top]

Governor's Veto of Naloxone Bill Draws National Attention

Last week Governor Paul LePage vetoed LD 1547, An Act to Facilitate Access to Naloxone Hydrochloride. The bill would allow pharmacists to dispense naloxone to persons at risk of experiencing opioid related overdoses as well as to friends and immediate family members of such persons and to first responders.

In his veto message Governor LePage stated, “Naloxone does not truly save lives; it merely extends them until the next overdose. Creating a situation where an addict has a heroin needle in one hand and a shot of naloxone in the other produces a sense of normalcy and security around heroin use that serves only to perpetuate the cycle of addiction.”  He went on to say that truly fighting the heroin crisis in Maine will require increased interdiction, expanded education and prevention efforts, and addressing opioid prescribing practices.

The veto has prompted reactions from Maine and around the country.  Writing in the Portland Press Herald, Dr. Joseph Valdez, an addiction specialist from Mercy Hospital said, “There is no doubt in my mind that LePage’s decision to veto bill L.D. 1547 will needlessly endanger the lives of Mainers. It calls into question his ability to lead our state during a time of unprecedented public health crisis.” MMA President Dr. Brian Pierce said, "The Governor missed an opportunity to remove needless government regulation (a prescription requirement) from a medicine that has proven safe, effective and lifesaving."

Baltimore City Health Commissioner Dr. Leana Wen, keynote speaker at the recent QC2016 conference in Augusta, said in a statement, “By vetoing this Bill, Governor LePage is perpetuating a dangerous myth:  that saving someone’s life with naloxone will only foster addiction.  This is unscientific, inhumane, and ill-informed.”

In a letter addressed to legislative leaders, the American Society of Addiction Medicine said, “Contrary to the Governor’s objections, expanding access to naloxone in Maine will most certainly save lives.  Naloxone is a fast-acting, inexpensive, non-addictive medication.”  The Executive Director of the American Medical Association wrote to those same legislators, “The governor’s reasons for vetoing LD 1547 have been raised before, and thankfully, the medical and behavioral research stands in opposition to the myths.”

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Upcoming Events


Beyond the Basics: Suicide Prevention, Intervention & Hope Across the Lifespan

The Beyond the Basics conference serves as a “best practice” conference offering participants in-depth and progressive information and the latest research in the field of suicide and suicide prevention. The conference is designed for an adult audience that has attained basic training and knowledge in suicide and suicide prevention, and wishes to expand their knowledge and ability to engage in suicide prevention in Maine. The 2016 theme, “Prevention, Intervention and Hope Across the Lifespan,” guides a program of the most up-to-date research on suicidology and evidence-based tools affecting various populations across generations, and provides participants with information to use in everyday practical applications.  Target Audience includes: School personnel, psychologists, psychiatrists, social workers, mental health professionals, alcohol and drug counselors, public safety professionals, military personnel, public health professionals, primary care physicians, physician assistants, nurses, families and community members. The keynote address is ‘Suicide Prevention: It’s All About Connection; by Susan Wehry, MD and is about self-directed violence, including fatal and non-fatal suicidal behavior, is a serious public health problem affecting all ages, and exacts a high toll on everyone it touches. Populations with high rates include youth, veterans and people over the age of 65.

To register:


MCMI Training Programs – Level 1 and Level 2

General Information for 2016

When and where held:

                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


Hanley Center for Health Leadership Health Equity & Cultural Competency 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

Additional questions can be sent to



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Job Openings


Seeking a BE/BC general or fellowship trained surgeon to join our expanding group.  Falmouth Orthopaedic Center is a well respected private practice in a vibrant orthopedic community. You will be partnering with 3 experienced surgeons each with an outstanding reputation in the area.

Located in Falmouth Maine (approximately 10 minutes from Portland, 2 hours from Boston) we pride ourselves on our four beautiful seasons, unlimited recreation, and top-ranking schools all within 10 minutes of the magnificent Maine coast. Falmouth is an excellent place to raise a family and offers a great quality of life with easy access to all the cultural amenities of the city of Portland.

This opportunity offers minimal ER call at a Level 2 community hospital with a competitive compensation package.  Our ideal candidate is a well trained general orthopedist or an orthopedist who is fellowship trained in foot and ankle, hand, pediatrics, sports medicine or adult reconstructive surgery.

Please send cover letter, CV, and inquiries to:


HOSPITALIST - Brunswick, Maine

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 Medicine. Procedures are not required. Excellent Intensivist and subspecialist support is available. New graduates and experienced candidates are encouraged to apply. 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 Internis 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.



Inland Hospital Family Practice is seeking a full time Family Medicine Physician without OB to join the employed practice in Oakland.

The practice has been serving the greater Waterville/Oakland area for many years. The practice provides care for infants, pediatrics through geriatric care. A competitive salary with incentives, plus full benefits is offered along with assistance with medical education debt, paid time off, paid CME, and relocation allowance. Qualifications: Board Certified/Eligible in Family Practice. This site is not eligible to sponsor a J-1 waiver.

Inland Hospital is a dynamic healthcare organization that believes in putting the patient first in every way. We are a 48-bed community hospital in Waterville; Lakewood, a 105-bed continuing care center on the hospital campus; 18 primary and specialty care physician offices in Waterville and five surrounding communities. Inland has been a proud member of EMHS since 1998. Inland patients have seamless access to a higher level of care when needed.

For further information, please contact:

Sherry Tardy, Director Business Development/Provider Recruitment, Inland Hospital by email at: or by phone at: 207-487-4085.


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



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.


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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