July 11, 2016

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Caring for ME: Learning Session Thursday on New Opioid Law

The Maine Medical Association and Quality Counts will present a full day of education on the new state law limiting the prescribing of opioid medication on this coming Thursday, July 14, at Maple Hill Farm in Hallowell.   There are some spaces still available so sign up today!  The initial elements of the law go into effect on July 29, 2016.

Successfully Implementing LD 1646/Chapter 488:

 An Act to Prevent Opiate Abuse by 

Strengthening the Controlled Substances Prescription Monitoring Program

Thursday, July 14, 2016  

8:00 AM - 4:00 PM

Maple Hill Farm, Hallowell ME 

Please join the Maine Medical Association and Maine Quality Counts for an educational Learning Session designed for providers to gain practical information on key issues related to implementing Maine's new law limiting opioid prescribing. The session is designed to provide training for clinician leaders in your organization and prepare them to train and support practice teams in complying with the new law.

Please note that space for this event is limited to the first 100 registrants. In order to allow for statewide participation, we are asking organizations to limit their initial registration to 6-8 clinical leaders. Should you have additional people who would like to register, please have them contact Linda Leighton to be added to the waiting list.

In order to cover costs of this event, there is a charge of $50 per person to attend.

Register by clicking here.


 Featured Presenters:

 Lisa Letourneau, Maine Quality Counts

 Gordon Smith, Maine Medical Association

 Thomas Sullivan, M.D., DrFirst

 Heather Skolfield, ME Prescription Monitoring Program

 Clare Desrosiers, ME Diversion Alert Program

 Noah Nesin, Penobscot Community Health Center 

 Jessica Bates, Penobscot Community Health Center

 Eva Quirion, St. Joseph Internal Medicine

 Stephen Hull, Mercy Pain Center

 Elisabeth Fowlie Mock, Eastern Maine Medical Center

 Peter Leighton, Bridgton Internal Medicine


 Learning Objectives: Participants will....

  • Increase their understanding of the current status of Maine's opioid epidemic and the key components of LD 1646/PL Chapter 488.
  • Learn an approach to balancing the quality of patient care while complying with the updated prescribing regulations included in LD 1646/PL Chapter 488.
  • Gain knowledge and skills on how to reduce misuse, abuse and diversion of prescription drugs.
  • Learn how to implement a team based approach to safe prescribing, including opioid dosing, compassionate tapering, and appropriate diagnosis.
  • Develop skills to facilitate difficult patient conversation and the use of functional assessments.
  • Share knowledge and skills gained throughout the day to help build competency in safe opioid prescribing within their practice setting.

To learn more about this upcoming event, please click here to review the draft agenda.

 Continuing Medical Education (CME) credit is available for this learning session. For American Disabilities Act (ADA) services, if special arrangements are required for an individual to attend this course please see contact provided below.

Contact Information:

Administrative Coordinator: 

Linda Leighton

Office: (207) 620-8526, ext. 1016

E-mail: lleighton@mainequalitycounts.org 

Sign Up Today for MMA's 163rd Annual Session in Bar Harbor, September 9-11, 2016

Register today to join your colleagues at the MMA's 163rd Annual Session being held at the Harborside Hotel in Bar Harbor, Sept. 9-11, 2016.  The theme of this year's meeting is Renewing the Joy & Passion in Medicine.  Three and one-half hours of CME is available.


Highlighting the educational sessions are Jo Shapiro, M.D., of Brigham & Women's Hospital in Boston and George "Joe" Dreher, Jr., M.D. from Maine Medical Center who along with colleague Christine Hein, M.D., will discuss the successful development and operation of a resilience program.  The keynote talk on Saturday will be presented by popular WCSH weatherman Kevin Mannix and his wife Linda Rota.  They will discuss their popular book, entitled Weathering Shame.   On Sunday morning, Nancy Hathaway, M.Ed, will once again offer her mindfulness program.

Other activities include the opening evening reception, the Sunday morning road race, the business meeting on Saturday morning, and the annual banquet on Saturday evening where MMA President Brian Pierce will present the President's gavel to Charles Pattavina, M.D. of Winterport.  Saturday evening also will feature annual MMA awards including the Mary Cushman, M.D., award for humanitarian service.

Registration is available on the MMA website at www.mainemed.com.  Hotel reservations can be made by calling the Harborside at 1-800-328-5033.  Any questions about the meeting can be directed to Diane McMahon at MMA via e-mail to dmcmahon@mainemed.com or by calling 622-3374, ext. 216.  Room reservations must be made by August 9th if you wish to stay at the Harborside.  Other accommodations are available.

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Jessa Barnard, Esq. Joins Vermont Medical Society as General Counsel and VP for Policy

MMA was thrilled to learn recently that our former Assistant General Counsel Jessa Barnard, Esq. has been named General Counsel and Vice President for Policy for the Vermont Medical Society.  A native of Vermont, Jessa had left MMA two years ago when her husband Justin accepted a position with a law firm in Burlington.  Jessa and Justin now reside in Montpelier with their two young children.

"In her four years at MMA, Jessa served the interests of Maine physicians with great distinction and forged a number of relationships in the public health arena that MMA continues to benefit from," noted Gordon Smith, MMA EVP.   "We could not be more proud of her being named to this significant position at VMS and we very much look forward to working with her again as the MMA and VMS interests intersect."

Jessa is no stranger to VMS as she previously served as policy specialist at VMS from 2002 to 2005 after graduation from Dartmouth College and before attending Stanford University School of Law.

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Proposed Medicaid Rule Would Impose New Obligations on Suboxone Providers


Today, the Maine Department of Health & Human Services (DHHS) held a public hearing on proposed amendments to the MaineCare Benefits Manual (MCBM), Chapters II & III, Section 65, Behavioral Health Services specifically dealing with Medication-Assisted Treatment (MAT).  The proposed amendments define MAT and affect both methadone clinics and Suboxone or buprenorphine providers, but would seem to have a greater impact on Suboxone providers because the State has not previously sought to regulate this practice.  MMA is concerned about the additional administrative burdens the proposed amendments would impose upon physicians providing Suboxone treatment and, accordingly, would hinder access to such treatment at this critical time.  Two examples mentioned at the hearing this morning were a requirement that a Suboxone provider be open for service 6 days per week and provide psychotherapy-type counseling associated with the treatment.  MMA urges you to review the proposed rule amendments cited below and provide your feedback to Andrew MacLean, Deputy EVP & General Counsel (622-3374, ext. 214; amaclean@mainemed.com) at your earliest convenience.  The comment deadline is Thursday, July 21st.

 You can find the rulemaking documents here.  Maine Public Radio's Susan Sharon covered the hearing this morning, so her piece likely will be on Maine Things Considered today at 5:30 p.m. [return to top]

2016 Mary Cushman Award Nominations Are Due By August 1

Nominations for the 2016 Mary F. Cushman Award for Exceptional Humanitarian Service as a Medical Volunteer are due by Monday, August 1st.  The award will be announced at the MMA's Annual Session in September.  The nomination form and brochure with additional information about the award is available at the Annual Session webpage.   [return to top]

HHS Announces $100 Million to Support Small Practices

The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) contained a provision to fund on-the-ground training and education for Medicare clinicians in solo or small group practices of 15 clinicians or fewer.  The U.S. Department of Health and Human Services (HHS) is required to award $20 million each year over the next five years for a total of $100 million to support small practices transitioning to the quality payment program.

The funds will help provide technical assistance to small practices—especially those in rural and medically underserved areas, as well as those in areas with health professional shortages.  The AMA has been pressing HHS to release these funds.

Organizations can apply to receive funding for our efforts to support physicians in this process.  To be eligible, organizations must be able to tailor training to clinicians and provide this education to them free of charge.

Learn more about the recent announcement and how to apply.
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AMA Provides Comment on MACRA Proposed Rule; MACRA Resources Available

In a letter dated June 27, 2016, the AMA provided extensive comments on the proposed rule, Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive Under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models (CMS-5517-P).  

The AMA also has a page on its web site dedicated to helping physicians understand the Medicare Access & CHIP Reauthorization Act (MACRA).
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Medical Boards Propose Rule Governing Telemedicine

The Board of Licensure in Medicine and the Board of Osteopathic Licensure recently released a proposed joint rule governing the use of telemedicine in the state. 

The proposed rule defines terms and sets forth practice guidelines, including provisions regarding establishing a physician-patient relationship in the telemedicine setting, technology requirements for physicians using electronic communications, and maintaining privacy and security.  You can read the proposed rule on the Board's website, here.

Comments on the proposed rules are due by 5:00 pm, Friday, July 15th.  MMA expects to file comments on the rule with the assistance of the AMA.  MMA members with interest in the rule should communicate with EVP Gordon Smith via e-mail to gsmith@mainemed.com.

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CMS Proposes 2017 Medicare Physician Fee Schedule

On July 7, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that updates payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2017.  The proposal includes a number of revised physician fee schedule policies that CMS says will improve Medicare payment for those services provided by primary care physicians for patients with multiple chronic conditions, mental and behavioral health issues, and cognitive impairment or mobility-related disabilities.  The goal is to reflect changes in medical practice and the relative value of services, as well as changes in the Medicare statute. 

Among the changes proposed for the Physician Fee Schedule are changes to the billing code set to more accurately recognize the work of primary care and other cognitive specialists to accommodate the changing needs of the Medicare patient population.  Some CPT codes will be revalued, new codes will facilitate separate payments for comprehensive assessment and care planning for patients with dementia and other cognitive impairments, and changes will be made in an attempt to reduce administrative burden associated with chronic care management.

In addition to the Physician Fee Schedule, changes are proposed to other Medicare Part B payments, the Medicare Shared Savings Program, and medical loss ratio reports submitted by Medicare Advantage and Part D plans.

Comments are due to CMS by 5:00 p.m. on September 6, 2016. [return to top]

HHS Announces New Measures to Fight Opioid Epidemic

The U.S. Department of Health & Human Services announced last week several new actions the Department is taking to combat the nation's opioid epidemic.  

  • The rule finalized by the Substance Abuse & Mental Health Services Administration (SAMHSA) includes expanding access to buprenorphine; it allows clinicians who have had a waiver to prescribe buprenorphine for up to 100 patients for a year or more, to now obtain a waiver to treat up to 275 patients.  Clinicians are eligible to obtain the waiver if they have additional credentialing in addiction medicine or addiction psychiatry from a specialty medical board and/or professional society, or practice in a qualified setting as described in the rule.

  • The rule also includes a proposal to eliminate any potential financial incentive for physicians to prescribe opioids based on patient experience survey questions.  HHS states that this is an attempt to address physicians' and other health care providers' concerns that patient survey questions about pain management in the Hospital Value-Based Purchasing program unduly influence prescribing practices.

  • The rule will require Indian Health Service prescribers and pharmacists to check state PMP databases before prescribing or depending opioids for pain.

  • In addition, the department is launching more than a dozen new scientific studies on opioid misuse and pain treatment and soliciting feedback to improve and expand prescriber education and training programs.

The measures are intended to build on the HHS Opioid Initiative, which was launched in March 2015 and is focused on three key priorities:  1) improving opioid prescribing practices; 2) expanding access to medication-assisted treatment (MAT) for opioid use disorder; and 3) increasing the use of naloxone to reserve opioid overdoses.  They also build on the National Pain Strategy, the federal government's first coordinated plan to reduce the burden of chronic pain in the U.S.

It is hoped that these federal initiatives will support the several activities going on in Maine to also respond to the epidemic, including the recommendations of the Maine Opiate Collaborative and the work of the Caring for ME initiative developed by MMA and Quality Counts.

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CMS Publishes 2015 Open Payments Data

The Affordable Care Act requires CMS to collect information from applicable manufacturers and group purchasing organizations (GPOs) in order to report information about their financial relationships with physicians and hospitals.

CMS recently has published the 2015 data for the Open Payments Program and you can find more information about the data on the CMS web site here.
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Job Openings

MEDICAL DIRECTOR SOUGHT for Mayo Regional Hospital Psychiatry and Counseling Clinic

Mayo Regional Hospital is seeking a part time Medical Director for its Psychiatry and Counseling clinic.  Mayo Psychiatry and Counseling provides mental health and substance abuse outpatient services, 5 days per week. The practice is staffed with a Director, Adult Psychiatrist, 2 PMHNP (child, adolescence and adult scope) and 7 clinicians.  The position would require 10-15 hours per week, with a combination on on-site and off-site work. Please contact, Lori Morrison, Vice President Physician Practices 207-564-4336 or lmorrison@mayohospital.com.



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: stardy@emh.org 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) 661-7383 or nathaa@mainehealth.org.



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:

                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)

               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



              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

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