Maine Medicine Weekly Update - June 3, 2019
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Maine AG Sues Purdue Pharma for Deceptive Opioid Marketing

Maine Attorney General Aaron Frey has filed a lawsuit in Kennebec Superior Court against Purdue Pharma, alleging unfair trade practices in opioid marketing.

Maine Attorney General Aaron Frey has filed a lawsuit in Kennebec Superior Court against Purdue Pharma, alleging unfair trade practices in opioid marketing. In doing so, Maine joins more than 40 other states and 2,000 local and tribal governments in suing the opioid manufacturer for deceptive and "relentless" marketing of its pain relief products. In 2012 Maine had the highest rate of opioid prescribing in the country.

The suit also names as defendants members of the Sackler family, primary owners of Purdue Pharma.

In a press release, the AG's office stated, “the Federal Substance Abuse and Mental Health Services Administration estimated that an average of 10,400 Maine residents each year struggled with opioid abuse disorder (including heroin use and pain relievers) between 2007 and 2016. Of the 2,206 opioid overdose deaths in Maine between 2007 and 2018 (numbers which include deaths involving heroin and non-prescription fentanyl), 1,321 were caused by prescription opioids. Of those deaths, 482 were caused by oxycodone.”

Purdue has denied the allegations.

You can read the AG's press release here.

Reported Measles Cases Continue to Rise

Reported 2019 measles cases in the US have risen to 971, higher than any annual total since 1992.

The US record of 763,000 was set in 1958, before the development of the measles vaccine. Vaccination began in  1963, and the rates fell precipitously from then until 1991. There was a bump up in 1992, then the rate dropped again, and in 2000 measles was considered to have been eliminated from the nation.

Of the 971 reported cases in 2019, 550 are in New York City, where there are pockets of measles spreading in communities opposed to vaccination.

More extensive discussion of the issue may be found at:  https://www.washingtonpost.com/health/2019/05/30/us-measles-cases-first-five-months-surpass-total-any-year-since/?noredirect=on&utm_term=.43eca4d83511

and https://www.npr.org/2019/05/30/728382757/new-u-s-measles-cases-breaks-25-year-old-record-health-officials-say?utm_campaign=KHN%3A%20First%20Edition&utm_source=hs_email&utm_medium=email&utm_content=73226494&_hsenc=p2ANqtz-8WBm1nqxqmUUCifUKf5e030peVyc5D8EjQmFoS9ZVJhXiwBcnMI1CJwR2Ncg79-JKE89qRCYsHp3wkGbc8tPbWBlpU3Q&_hsmi=73226494

New HIPAA Guidelines for Business Associates

A new fact sheet from the US DHHS Office of Civil Rights sets out HIPAA requirements for business associates.

[from Maine Hospital Association Friday Report]

The US Department of Health & Human Services Office of Civil Rights (OCR) has issued a fact sheet on the Health Insurance Portability and Accountability Act (HIPAA) requirements for business associates under the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH).

AMA Opioid Task Force Recommendations Offer Roadmap to Policymakers

The task force's new recommendations focus on barriers to treatment for substance use disorder and pain and other policies that result in so few patients receiving care. These include prior authorization, step therapy and other administrative burdens as well as inadequate enforcement of state and federal parity laws.

[from AMA Advocacy Update]

The AMA Opioid Task Force released recommendations calling on policymakers to eliminate barriers to treatment and to take additional steps to end the nation's opioid epidemic. The task force's new recommendations focus on barriers to treatment for substance use disorder (SUD) and pain and other policies that result in so few patients receiving care. These include prior authorization, step therapy and other administrative burdens as well as inadequate enforcement of state and federal laws that require insurance parity for mental health and SUDs.

"We need help from policymakers to ensure that more people have access to treatment. Physicians are responding to the epidemic and we are seeing results: a 33% reduction in opioid prescribing since 2013, increased use of prescription drug monitoring programs, enhanced education and greater co-prescribing of naloxone," said AMA President-elect Patrice A. Harris, MD, MA, who also is chair of the task force. "But we cannot enforce parity laws, or eliminate administrative barriers without the help of state and federal authorities, and that's what's limiting treatment now."

The new recommendations:

• Remove prior authorization, step therapy and other inappropriate administrative burdens or barriers that delay or deny care for U.S. Food and Drug Administration (FDA)-approved medications used as part of medication-assisted treatment for opioid use disorder.
• Support assessment, referral and treatment for co-occurring mental health disorders, as well as enforce state and federal laws that require insurance parity for mental health and substance use disorders.
• Remove administrative and other barriers to comprehensive, multimodal, multidisciplinary pain care and rehabilitation programs.
• Support maternal and child health by increasing access to evidence-based treatment, preserving families and ensuring that policies are nonpunitive.
• Support reforms in the civil and criminal justice system that help ensure access to high quality, evidence-based care for opioid use disorder, including medication-assisted treatment.

"The original task force recommendations called on physicians to accept the responsibility to take a leadership role in ending the epidemic," Dr. Harris said. "Yet, more people are dying each year, emphasizing the need for policymakers to protect patients' access to evidence-based care for pain and for opioid use disorder."

The original task force recommendations, issued in 2015, focused on actions that physicians could take to help end the epidemic:

• Register for and use state prescription drug monitoring program
• Enhance education and training on effective, evidence-based treatment
• Support comprehensive care for patients in pain and those with a substance use disorder
• Remove stigma. Patients with pain and with a substance use disorder deserve comprehensive care and compassion, not judgment.
• Expand access to naloxone in the community and through co-prescribing
• Encourage safe storage and disposal of opioids and all medications

The AMA Opioid Task Force is comprised of the American Medical Association, American Osteopathic Association, and 25 specialty and state medical societies as well as the American Dental Association. Learn more about what the AMA is doing to end the opioid epidemic at end-opioid-epidemic.org.

This Week's Public Health Updates from the AMA

Click through for a brief update on recent public health issues, provided by the American Medical Association's electronic publication, Morning Rounds. [This article is updated weekly.]

Olaparib helps patients with advanced pancreatic cancer who carry BRCA gene mutations go longer without disease worsening, research indicates

Reuters (6/2, Steenhuysen) reported that research indicated “Lynparza [olaparib] helped patients with advanced pancreatic cancer who carry BRCA gene mutations go longer without their disease worsening than those who received a placebo.”

CNN (6/2, Howard) reported that the “study involved 154 patients whose pancreatic cancer had not progressed while being previously treated with a platinum-based chemotherapy.” CNN adds, “Between 2015 and this year, those patients were randomly assigned to either receive olaparib as a type of maintenance care or to receive a placebo.” Investigators found, “two years into the study...that 22.1% of the patients in the olaparib group versus 9.6% of patients in the placebo group did not see their disease progress.” The findings were presented at the American Society for Clinical Oncology’s annual meeting.

Adverse childhood experiences may increase likelihood of sleep problems in adulthood

Reuters (5/31, Rapaport) reported researchers found “children who suffer adverse experiences like abuse and neglect may be more likely to have sleep problems in adulthood.” The findings were published in the journal Sleep.

NYTimes highlights struggles faced by children whose families are addicted to opioids

The New York Times (5/31, A1, Levin) reported that “more than 20 years after the introduction of OxyContin [oxycodone hydrochloride] – and nearly 400,000 opioid overdose deaths later – a generation is growing up amid the throes of a historic epidemic.” The Times continued, “Call them Generation O: the children whose families are trapped in a relentless grip of addiction, rehab and prison.” In a country “where more than 130 people die every day from an opioid overdose...school is for many students a refuge; a place where they attend classes, but also have access to hot meals, hot showers and donated clean clothes.” The Times highlighted the struggles faced by children whose families are addicted to opioids.

Pembrolizumab lifts survival rate for individuals with lung cancer, data indicate

Reuters (6/1, Steenhuysen) reports that “nearly a quarter of patients who received” Keytruda (pembrolizumab) “as an initial treatment for advanced lung cancer were still alive after five years, according to data presented at” the American Society of Clinical Oncology meeting. According to Reuters, “That represents a huge gain over the historical five-year survival rate of just 5 percent for those with the disease prior to the introduction of medicines like Keytruda that spur the immune system to fight cancer.”

Ribociclib can improve survival in certain patients with breast cancer, study indicates

The New York Times (6/1, Grady) reports that ribociclib, “a drug that can slow the progression of advanced breast cancer, has been shown for the first time to lengthen survival in women whose disease started before or during menopause, researchers reported” at the annual meeting of the American Society of Clinical Oncology.

“Ultra thin” stent offers better results than thicker versions, study suggests

The Minneapolis Star Tribune (6/1, Carlson) reported that “a new generation of stents with very thin components are being implanted in patients and monitored for years in clinical trials to see if they offer better results than slightly thicker versions of the same devices.” Study findings published in JAMA Cardiology “show that, indeed, a European stent made...with ‘ultra thin’ components helped patients avoid do-over procedures to ‘re Biotronik vascularize’ the same vessel better than wider stents did.” Biotronik’s “device had less than half the rate of do-over vascularizations compared to an older Medtronic stent in small vessels, and it also showed better performance on that measure than a premium-priced Boston Scientific stent designed in Minnesota.”

Research links ACA to reduction in racial disparities in care of cancer patients

The Washington Post (6/2, McGinley) reports that “research links the” Affordable Care Act “to a reduction in racial disparities in the care of cancer patients and to earlier diagnoses and treatment of ovarian cancer.” According to investigators “involved in the racial-disparity study, before the ACA went into effect, African Americans with advanced cancer were 4.8 percentage points less likely to start treatment for their disease within 30 days of being given a diagnosis.” Now, however, “black adults in states that expanded Medicaid under the law have almost entirely caught up with white patients in getting timely treatment, researchers said.” Meanwhile, another study indicated “that after implementation of the law, ovarian cancer was diagnosed at earlier stages and that more women began treatment within a month.” The findings were presented at the annual meeting of the American Society of Clinical Oncology.

AD/HD may be more common in elite athletes, review indicates

Reuters (5/31, Crist) reported that attention-deficit/hyperactivity disorder (AD/HD) “may be more common in elite athletes,” researchers concluded after conducting a medical literature review. The findings were published online May 16 in the British Journal of Sports Medicine.

Governor Mills Announces Opioid Response Summit July 15th

Day-long summit will bring together national and state leaders to collaborate on the state’s ongoing response to the opioid crisis and help inform future initiatives to combat it.

Governor Janet Mills announced last Thursday that her Administration will convene an Opioid Response Summit on July 15, 2019 at the Augusta Civic Center. The summit, “Turning the Tide: Maine’s Path Forward in Addressing the Opioid Crisis,” will bring together members of the public, health providers, experts, affected individuals and families, and law enforcement officials from across Maine to foster collaboration on the state’s ongoing response to the opioid crisis. The summit will feature national policy experts Michael Botticelli, President Barack Obama’s Director of National Drug Control Policy, and Sam Quinones, journalist and author of the landmark book,Dreamland, which chronicles the national opioid crisis and is widely credited with awakening public interest in the issue. Both will deliver keynote remarks.

“While we have made strides in expanding access to treatment and recovery, investing in prevention and education, and supporting law enforcement, we have much more to do to stem the tide of this deadly epidemic,” said Governor Mills. “This summit will bring together national and state leaders to give us feedback on our actions and provide new ideas to inform our work on this critical issue.”

“I am honored Michael Botticelli and Sam Quinones have agreed to keynote this summit and share their experience, knowledge and recommendations with our public health officials, legislators, state and local government officials, and the public as Maine continues to tackle the opioid epidemic,”said Gordon Smith, Director of Opioid Response. “I look forward to convening this summit and advancing our work to build a stronger, healthier Maine.”

“Tackling the opioid crisis is part of our broader effort to address substance use disorders, mental health challenges, and prevention – giving Mainers the tools to get and stay healthy,”saidMaine Department of Health and Human Services Commissioner Jeanne Lambrew. “We value this opportunity to achieve consensus on how to address opioid use disorder, which touches every facet of Maine’s population, from workforce issues and health care costs, infants and families, to the state’s oldest residents.”

In addition to keynote presentations from Botticelli and Quinones, Governor Mills and Commissioner Lambrew will deliver remarks. The day-long summit will feature additional presentations on actions taken by neighboring states and new threats such as the emergence of deadly synthetic drugs. There will be breakout sessions moderated by experts on issues ranging from recovery support strategies to community coalitions. Registration will be open to the public in the coming weeks, at a cost of $40.00 per attendee, to cover the cost of lunch.

According to the Attorney General’s Office’s 2018 Drug Death Report, drug overdose deaths decreased in 2018, but Maine's opioid crisis continues to be a public health epidemic requiring a comprehensive response from jurisdictions inside and outside of state and local government. While the total number of 354 drug fatalities during 2018 was lower than the 417 deaths reported in 2017, 80 percent were caused by opioids, often in combination with other drugs or alcohol. At least 89 percent of those deaths were attributed to accidental overdoses.

MedHelp Maine Seeks Data on Unaffordable Medicines

Do you have patients who can't afford to fill their prescriptions or who skip doses or split tablets to save money? Does this medication nonadherence result in avoidable hospitalizations and compromised health?

Unaffordable Medicines?

Do you have patients who can't afford to fill their prescriptions or who skip doses or split tablets to save money? Does this medication nonadherence result in avoidable hospitalizations and compromised health?

As many as 30% of prescriptions are never filled and 50% of medications for chronic diseases are still not taken as prescribed.  This medication nonadherence is not only a problem for the low-income uninsured, but increasingly also a concern for Medicare beneficiaries and other insured individuals with high deductibles and copays.  It results in at least 10% of all hospitalizations and more deaths than from opioid overdose, diabetes, influenza and pneumonia, or kidney disease.

If you are a regular prescriber of medicines for adult outpatients, please help develop solutions by completing this brief survey.  https://www.surveymonkey.com/r/CWTXZM8

To offer comments or to speak with surveyor MedHelp Maine, contact Martha Morrisson at medhelpmaine@gmail.com or (207) 793-4462.

MMA Legislative Call Tuesday, June 4th

The Maine Legislature is in full swing, with over 1760 bills printed. As we approach statutory adjournment date (June 19th), public hearings and work sessions are beginning to tail off while voting on bills increases. There's still work to do on the MMA Legislative Calls. The next call will be Tuesday, June 4th, at 8 p.m.

MMA Legislative Committee Chairs Jay Mullen, M.D. and Lindsey Tweed, M.D. welcome you to participate in the weekly conference calls of the MMA Legislative Committee.

The last MMA Legislative Committee weekly conference call for the First Regular Session of the 129th Maine Legislature will take place Tuesday, June 4th, 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. To date the Legislature has printed approximately 1700 bills, and as the deadline for committee consideration is approaching the number of bills printed each week is beginning to dwindle. While that makes the work of the legislative call shorter, it also allows for more in-depth discussion of significant matters.

Please use the following conference call number and passcode. These will remain the same for every weekly call during the session.

Conference call number: 1-603-766-5646

Participant ID - 699139#

The purpose of the weekly conference calls is to discuss 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 following are bills of interest to the physician community printed last week. (For those not familiar with the term, a "concept draft" is a bill that contains only a title and a brief description of what it is intended to do. It does not contain the actual bill text.) We will discuss the priority bills marked with an asterisk (*) first.

Following are the bills of the week: 

June 4, 2019

LD 1809,  Resolve, To Increase Funding for Evidence-based Therapies for Treating Emotional and Behavioral Problems in Children. Increased rates for MST, MST for problem sexualized behavior, and FFT; requires rate study with report to HHS Committee.

LD 1811,  An Act To Enhance Personal and Public Safety by Requiring Evaluations of and Judicial Hearings for Persons in Protective Custody Regarding Risk of Harm and Restricting Access to Dangerous Weapons. A variation on the “red flag” bill, requires law enforcement to take subject into protective custody and deliver to medical practitioner for evaluation and potential restricted access to firearms.

LD 1813,  Resolve, To Ensure Safe and Inclusive Learning Environments. Working group to study LGBTQ inclusiveness in the school environment.

LD 1816,  An Act To Ensure the Safety and Well-being of Infants Affected by Substance Exposure. Modernizes language and modifies reporting requirement and service referrals for substance affected infants; reflects changes in federal law.

LD 1822,  An Act To Protect Access to Services for Adults with Serious and Persistent Mental Illness. Informal DHHS review process for persons claiming denial of access to services by providers contracting with the Department. Provides for right of civil action in Superior Court after that.

LD 1825,  An Act To Authorize Limited Disclosure of Cigarette Sales Information To Ensure Continued Receipt of Tobacco Settlement Funds. Technical amendment to allow better computation and dispute resolution re: tobacco Master Settlement Agreement.

LD 1831,  An Act To Correct Inconsistencies, Conflicts and Errors in the Laws of Maine. Mostly technical language and spelling corrections.

"Death With Dignity" Bill Passes House and Senate, and Other State House Highlights of the Week

A summary of the MMA's legislative advocacy at the Maine State House last week.

LD 1313, the "Death With Dignity" bill, passed both House and Senate in the first pass this week, and today (Monday) the enactment vote in the House passed by one vote. The final enactment vote in the Senate is expected later this week.

Roll call votes were held in the House and Senate, and today's enactment vote in the House, 73-72, was also by roll call. One House seat is vacant, and there were three representatives absent and two excused.

The Criminal Justice and Public Safety Committee held work sessions on some of the firearm safety bills last week. LD 379 (safe storage) had a committee vote of 8-4 against passage, although we believe that vote may not be an accurate indication of its chances of passage. LD 1276 (background checks) was completely modified in a proposed amendment and had a divided vote in Committee. There was an evenly divided, 6-6 vote on LD 1099 (waiting periods for purchase).  The vote on LD 533, a "stand your ground" bill supported by the NRA and SAM, was 7-4 against passage.

In the Judiciary Committee the "red flag" bill, LD 1312, did not fare well; however, there is a new bill, LD 1811, which will have a public hearing on June 5th and a work session June 6th. This modified red flag bill is being negotiated among various parties, and it is too soon to know what its form will be coming out of committee.

The legislature's committee work is almost finished. On June 3rd the Legislature moved to a 5-day-per-week schedule of full sessions in the House and Senate, where members will debate divided committee reports and process unanimous reports through the consent calendar with a goal of meeting the June 19th statutory adjournment deadline.

Upcoming Specialty Society Meetings

Below you will find an on-going list of Upcoming Specialty Society Meetings.  Any questions should be referred to the contact person listed for each specialty.

Below you will find an on-going list of Upcoming Specialty Society Meetings.  Any questions should be referred to the contact person listed for each specialty.

UPCOMING SPECIALTY SOCIETY MEETINGS

June 27, 2019
Maine Chapter, American College of Emergency Physicians Chapter Meeting
Cabbage Island Clam Bake – Boothbay Harbor, ME
Contact: Cathy Stratton at 207-592-5725 or cstratton@mainemed.com

September 7, 2019
The following Specialty Society Meetings are being held in conjunction with MMA’s 166^th Annual Session taking place September 6-8, 2019 at the Harborside Hotel & Marina in Bar Harbor, ME

Maine Chapter, American College of Surgeons
Time TBA
Contact: Cathy Stratton at 207-592-5725 or cstratton@mainemed.com

Maine Chapter, American College of Emergency Physicians
Time TBA - Ironbound Room in the Pool House
Contact: Cathy Stratton at 207-592-5725 or cstratton@mainemed.com

Maine Society of Anesthesiologists
2:00pm – 5:00pm – Stave Island Room in the Pool House
Contact:  Lisa Montagna at 207-620-4015 or mesahq@gmail.com

September 20, 2019
Maine Society of Eye Physicians and Surgeons Fall Business Meeting
(Held in conjunction with the 17^th Annual Downeast Ophthalmology Symposium)
Harborside Hotel & Marina – Bar Harbor, ME from 10:30am – 11:45am
Contact:  Shirley Goggin 207-445-2260 or sgoggin@mainemed.com

September 20-22, 2019
18^th Annual Downeast Ophthalmology Symposium
(Presented by the Maine Society of Eye Physicians and Surgeons)
Harborside Hotel & Marina – Bar Harbor, ME
Contact:  Shirley Goggin 207-445-2260 or sgoggin@mainemed.com

December 11, 2019
Maine Chapter, American College of Emergency Physicians Chapter Meeting
Portland Regency Hotel – Portland, ME
Contact: Cathy Stratton at 207-592-5725 or cstratton@mainemed.com

February 7-9, 2020
Maine Urological Association & Rhode Island Urological Society’s 2020 Winter Program
Sugarloaf Mountain Hotel & Conference Center – Carrabassett Valley, ME
Contact: Dianna Poulin at 207-480-4194 or dpoulin@mainemed.com

April 23-24, 2020
Maine Association of Psychiatric Physicians, 14^th Annual Spring Program
Hilton Garden Inn, Freeport, ME
Contact Dianna Poulin at 207-480-4194 or dpoulin@mainemed.com

Assessing and Managing Non-Suicidal Self-Injury and Suicide Risk in Healthcare Settings - 3 Hour CME Training for Healthcare Professionals at MMA on Friday, June 21, 2019

Assessing and Managing Non-Suicidal Self-Injury and Suicide Risk in Healthcare Settings -  3 Hour CME Training for Healthcare Professionals at MMA on Friday, June 21, 2019.

Assessing and Managing Non-Suicidal Self-Injury and Suicide Risk in Healthcare Settings -  3 Hour CME Training for Healthcare  Professionals

Friday, June 21, 2019

Maine Medical Association – 30 Association Drive, Manchester

8:30 am – Welcome/Continental Breakfast,   9:00 am – Program begins

Suicide is the 9^th leading cause of death in Maine and the incidence of suicide in Maine has increased almost 25% in the last decade.   Non-suicidal self injury, most frequently intentional cutting or self-burning has also increased markedly over the past decade.  These behaviors are increasingly being identified, assessed and managed within healthcare settings. 

This professional training offers an opportunity to learn valuable knowledge and skills in the function, assessment and management of non-suicidal self injury.  The second part of the training will address suicide prevention and management within the framework of Suicide Safe Care, a systemic approach that increases safety and support for someone at risk.  This evidence-based approach includes screening and assessment of risk, intervention, Collaborative Safety Planning and assured follow-up with anyone at risk for suicide. 

Presented by: Greg A Marley, LCSW, Clinical Director, NAMI Maine - Greg Marley has practiced in the field of community mental health and prevention in Maine for over 30 years. 

 REGISTER HERE

Sponsored by the CDC Maine Suicide Prevention Program,
NAMI Maine, and the Maine Medical Association

Quality Counts: Rapid Induction Starting in the ED (RISE) Training, Webinars, ECHO Program

Quality Counts is hosting an education program for hospital Emergency Departments (EDs) with training and technical assistance on initiating buprenorphine in the ED.

Quality Counts (QC), in collaboration with BlueWater Emergency Partners and several other partners (MMA and ACEP) is working under a contract with the state of Maine to host an education program for interested hospital Emergency Departments (EDs) focusing on how to initiate buprenorphine in the ED.  During the Rapid Induction Starting in the ED (RISE) project, QC plans to offer a range of learning methods, including both in-person and virtual events, to provide education and assistance on best practices for initiating buprenorphine in hospital EDs for individuals with Substance Use Disorder (SUD) who are willing to engage in treatment during an ED visit.

If your ED is interested in receiving training or technical assistance on initiating buprenorphine in the ED from peer coaches in the field please contact Kayla Cole at kcole@mainequalitycounts.org or tel. 207-620-8526 ext. 1027.

Additionally, as part of our project RISE educational programming, we will offer a four-month ECHO program that will convene a "hub" of faculty experts and clinicians as well as three one-hour webinars.  Our team will engage clinicians and teams from hospital EDs that have and/or are planning to implement MAT in the ED to serve as "spokes", giving them the opportunity to learn together and discuss specific questions and challenging issues through case discussions.  Content for the ED MAT didactic sessions in the ECHO program will reflect key educational topics related to initiating MAT in the ED, with specific content to be developed with input from ED and addiction medicine expert consultants, as well as from targeted ED clinicians and staff around the state.  If you are interested in these educational opportunities please hold the following dates.  If you have questions or would like more information please contact Kayla Cole at kcole@mainequalitycounts.org or tel. 207-620-8526 ext. 1027.

ECHO Dates:

• May 22, 2019 from 12:00-1:00 PM
  
• June 26, 2019 from 12:00-1:00 PM
• July 24, 2019 from 12:00-1:00 PM
• August 28, 2019 from 12:00-1:00 PM

• June 5, 2019 from 12:00-1:00 PM
  
• June 12, 2019 from 12:00-1:00 PM
• June 19, 2019 from 12:00-1:00 PM
  

MICIS 2019 Clinical and Legal Opioid Update - June 5 in Augusta

Join us for this three-hour presentation by the Maine Independent Clinical Information Service (MICIS): Wednesday, June 5 at the Augusta Civic Center.

2019 Clinical and Legal Opioid Update

Augusta: Wednesday, June 5, 2019 at the Augusta Civic Center  Register for June 5 in Augusta

5:00 PM -8:30 PM
Check-in begins at 4:30 PM

Free - advance registration is required
Light snacks will be provided

Topics:

• 2019 Clinical Opioid Update
• 2019 Legal Opioid Update
• Co-Prescribing Benzodiazepines and Opioids: The Black Box of Increased Overdose Risk

Presenters: Elisabeth Fowlie Mock, MD, MPH and Peter Michaud, JD, RN

The Maine Medical Education Trust designates this live activity for a maximum of 3 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Maine Medical Education Trust and the Maine Independent Clinical Information Service (MICIS). The Maine Medical Education Trust is accredited by the Maine Medical Association Committee on Continuing Medical Education and Accreditation to provide continuing medical education for physicians.

The Maine Independent Clinical Information Service is a program of the Maine Medical Association. For information about MICIS, visit www.micismaine.org. 

This activity qualifies for a maximum of 3 credits of the 3 CME credit requirement for opioid medication education found in P.L. 2015, Chapter 488, Maine's legislation to address the opioid drug crisis.

Maine Professionals Health Program 1-day wellness conference June 13, 2019 - Augusta Civic Center

The MPHP is inviting all interested to join us for a comprehensive 1-day wellness conference on Thursday, June 13^th, 2019

The MPHP is inviting all interested to join us for a comprehensive 1-day wellness conference on Thursday, June 13^th, 2019 at the Augusta Civic Center, Augusta, Maine. Designed to help gain a better understanding of the varying factors affecting Maine’s medical professionals, a variety of topics will be covered. Including, but not limited to; medication assisted treatment and recovery considerations, opioid prescribing practices for the treatment of chronic pain, and self-care methods and earlier intervention in addressing these issues. Notably, MPHP participants will speak on their experiences with addiction, recovery, and wellness.

This conference has been approved for 6 CMEs and 6 CEUs

Join us for our biennial conference on Professional’s Health and Wellness at the Augusta Civic Center on Thursday, June 13th, 2019. 

Brochure 

2019 Jurisdiction K Listening Tour - June 18 - South Portland

National Government Services, serving as your Medicare Administrative Contractor (MAC), is dedicated to providing superior customer service and is committed to finding new ways to improve upon that service. We appreciate your commitment to excellence, your efforts in working with us and in serving our beneficiary community. As a result, we are inviting you to participate in the annual ‘National Government Services Listening Tour’. Meeting sites have been set up by state and you are invited to attend the location nearest you.

National Government Services, serving as your Medicare Administrative Contractor (MAC), is dedicated to providing superior customer service and is committed to finding new ways to improve upon that service. We appreciate your commitment to excellence, your efforts in working with us and in serving our beneficiary community. As a result, we are inviting you to participate in the annual ‘National Government Services Listening Tour’. Meeting sites have been set up by state and you are invited to attend the location nearest you.

2019 Jurisdiction K Listening Tour

South Portland, ME
Tuesday, June 18, 2019
11:00 p.m. - 3:00 p.m.
Anthem Building, 2 Gannett Drive (See 1st Floor - Security)
                                                                    

What to Expect:

During this event, we will sit down with you and listen to your ideas about how we can improve in areas such as:

• Initiatives to reduce provider burden, rural provider issues and patients over paperwork
• Customer service you receive when contacting our call center
• Training you receive during our webinars and in-person events
• Ease of use of our website, www.NGSMedicare.com and Internet portal, www.NGSConnex.com
• Our provider enrollment and provider revalidation processes
• Timeliness and accuracy of our claims processing and payments
• Claim denials and appeals
• Processes where you find it difficult to do business with us
• Actions we could take to help make your job easier

Please RSVP with your attendance to Lori Langevin at lori.langevin@anthem.com no later than two weeks prior to the meeting date to let us know you can attend. We look forward to partnering with you and discussing your ideas for future improvements. If you have suggestions, but are unable to attend in person, please send your suggestions to lori.langevin@anthem.com.

The Maine Concussion Management Initiative Will Be Offering Training Programs – June 21 and October 29

The Maine Concussion Management Initiative will be offering two training programs in 2019. The first will be June 21 in Waterville at Colby College. And the second on October 29 in South Portland at the Double Tree hotel as the Youth Concussion track at the annual conference of the Brain Injury Association of America-Maine Chapter.

The Maine Concussion Management Initiative will be offering two training programs in 2019. The first will be June 21 in Waterville at Colby College. And the second on October 29 in South Portland at the Double Tree hotel as the Youth Concussion track at the annual conference of the Brain Injury Association of America-Maine Chapter. Online registration will be available in September.

Level 1 is the Introduction to Concussions and Concussion Management. Level 2 is Advance Concussion Management that includes interpreting neurocognitive tests. Level 1 will be held in the morning and Level 2 will be held in the afternoon. Level 1 is a prerequisite for Level 2.

MCMI training is appropriate for physicians, nurse practitioners, physician assistants, neuro-psychologists, school nurses, athletic trainers, physical therapists, occupational therapists, athletic administrators/directors, and coaches.

For more information or to register:

2019 General Information sheet

2019 Registration form

At this time online registration through the MCMI website is not available – you will need to mail in your registration and payment. For any questions – please contact: Jan Salis, PT, ATC, at jsalis@aol.com or 207-577-2018.

2019 Mary Cushman, MD Award for Exceptional Humanitarian Service as a Medical Volunteer

The Maine Medical Association presents the Mary F. Cushman Award each year to recognize the humanitarian service of Maine medical volunteers.  Nominations for the 2019 award are due by July 31.

Nominations for the 2018 Mary Cushman, MD Award for Exceptional Humanitarian Service as a Medical Volunteer

The Maine Medical Association presents the Mary F. Cushman Award each year to recognize the humanitarian service of Maine medical volunteers who serve many hours in Maine, throughout the United States, or abroad.  The award is announced at the Association’s Annual Session, and includes a $1,000 donation to the institution or organization of the recipient’s choice.  Priority consideration is given to:

• the nomination of a Maine physician who is a member of the Maine Medical Association.
• nominations submitted by members of the Maine Medical Association.
• nominations that, for international volunteering, include training people in other countries to provide care in their own communities.

Nominations for the 2019 award are due by July 31 and should describe the volunteer’s activities and contributions to the profession.

The nomination form is available at https://www.mainemed.com/cme-education-info/2019-annual-session.

Maine Independent Clinical Information Service 2019 Presentations

2019 MICIS learning objectives and descriptions are available at www.micismaine.org.

MICIS, the Maine Independent Clinical Information Service, has been providing evidence-based prescribing education since 2008.  In 2019, MICIS is offering presentations on the following topics:

• Clinical Opioid Update 2019
• Legal Opioid Update 2019
• Co-prescribing Benzodiazepines & Opioids: The Black Box of Increased Opioid Risk
  
• Opioid Use Disorder & Medication-Assisted Recovery: Caring For Our Communities (presented in 2018)
  
• Managing Depression in Older Patients (Note: this is not an opioid topic.)

In addition, individual academic detailing sessions are available to prescribers of opioids on these topics:

• Treating Complex Patients with Chronic Pain who are Prescribed Opioids
• Overview of Office-Based Buprenorphine Prescribing
  

Visit www.micismaine.org for information about MICIS education outreach and academic detailing, and to request a presentation at your medical practice, hospital or conference.

Family Medicine Specialist or an Internist

Northern Light AR Gould Hospital is seeking an additional Family Medicine Specialist or an Internist for its outpatient health facility in Presque Isle.  This is an outpatient only position with 24/7 Hospitalist support for all admissions.

Northern Light AR Gould Hospital is seeking an additional Family Medicine Specialist or an Internist for its outpatient health facility in Presque Isle.  This is an outpatient only position with 24/7 Hospitalist support for all admissions.

AR Gould Hospital features 89 acute care beds and a 72 bed facility and serves all of Aroostook County with a broad array of primary and specialty care, acute inpatient, diagnostic and surgical services.

Northern Light AR Gould Hospital in Presque Isle, Maine is the county seat of Aroostook County, which is known for its beautiful lakes, rivers, and forests.  When you’re not enjoying year round outdoor activities, you will be working with supportive colleagues in a modern facility that is well-integrated into a cutting-edge health care syste

For confidential consideration, please contact: Monica Hewitt, Physician Recruiter ProviderJobs@NorthernLight.org or 207.973.5358.

8/12/19

Physician (BC/BE in Family Medicine)

Belgrade Regional Health Center seeks a Physician (BC/BE in Family Medicine) to provide primary care to people of all ages. As a NCQA-Patient-Centered Medical Home, the health center offers accessible, high quality healthcare with integrated behavioral health services.

Belgrade Regional Health Center seeks a Physician (BC/BE in Family Medicine) to provide primary care to people of all ages. As a NCQA-Patient-Centered Medical Home, the health center offers accessible, high quality healthcare with integrated behavioral health services.

Founded in 1977, we serve over 2,300 residents and travelers each year. We reside in the peaceful, picturesque, and welcoming Belgrade Lakes region in the heart of central Maine, renowned for its chain of seven sparkling lakes and abundant streams. Belgrade is part of HealthReach Community Health Centers, a group of eleven Federally Qualified Health Centers in Central and Western Maine serving 28,000 residents in 80 Maine towns.

We offer competitive salary and benefits, pension plan with employer match, malpractice coverage, and loan repayment options. EOE. Contact: Recruiter, HRCHC, 10 Water Street, Suite 305, Waterville, ME 04901 | (207) 660-9913 | Fax: (207) 660-9901 | Communications@HealthReach.org | www.BelgradeCHC.org

BC/BE Family Medicine or Internal Medicine Physician

Northern Light Eastern Maine Medical Center has an exciting leadership opportunity for a BC/BE Family Medicine or Internal Medicine Physician to lead our primary care network of five well-established, quality-driven, outpatient practices serving the greater Bangor community.

Northern Light Eastern Maine Medical Center has an exciting leadership opportunity for a BC/BE Family Medicine or Internal Medicine Physician to lead our primary care network of five well-established, quality-driven, outpatient practices serving the greater Bangor community.

The Physician Director, Primary Care will collaborate with the Practice Director, Primary Care to form a dyad partnership in leading our primary care team, as well as provide peripheral oversight for our Walk In Care and university health center locations. The Physician Director of Primary Care will have clinical, operational, financial and strategic duties. This role is 80% administrative and 20% clinical practice.

Why Northern Light Health? We offer a robust compensation and benefits package, generous PTO benefits, loan repayment program, and an exceptional work/life balance.

For confidential consideration, please contact:
Amanda Klausing, FASPR, Physician Recruiter
ProviderJobs@NorthernLight.org
207.973.5358

6/3/19

Family Medicine Opportunity in Beautiful Western Maine

Western Maine Primary Care, a department of Stephens Memorial Hospital, is currently seeking a BC/BE family medicine physician to join our exceptional team of providers.

Western Maine Primary Care, a department of Stephens Memorial Hospital, is currently seeking a BC/BE family medicine physician to join our exceptional team of providers. Western Maine Primary Care is committed to providing high quality care. Now is a great time to join our team as we recently relocated our practice to our brand new, state-of-the-art medical office building.

Stephens Memorial Hospital, a 25-bed critical access hospital, is a part of the MaineHealth family, the premier healthcare system in Maine, and is nationally renowned for its innovative programs in rural healthcare. This position offers teaching opportunities of medical students, as Stephens Memorial Hospital is one of the teaching sites for the Maine Medical Center – Tufts University Medical School program. Come be a part of our dynamic team of providers and exceptional support staff and experience the warmth of a small town combined with a medical community working closely with colleagues throughout the MaineHealth system.

Competitive salary and benefits, including student loan repayment and relocation assistance. FMI please contact Abbie Graiver, Director of Physician Recruitment at (207) 744-6049 or graiverab@wmhcc.org.

PCHC in need of Pediatrician for Brand New Pediatric Center!

Penobscot Community Health Care is seeking a Pediatrician in our Penobscot Pediatrics in Bangor. Become a part of the legendary Penobscot Pediatrics, at our new location set to open fall of 2019.

Penobscot Community Health Care is seeking a Pediatrician in our Penobscot Pediatrics in Bangor. Become a part of the legendary Penobscot Pediatrics, at our new location set to open fall of 2019. Penobscot Peds has been a staple amongst the Bangor community for over 30 years! We are the largest and most comprehensive FQHC in Maine and the 2^nd largest in New England. Seaport and Penobscot Pediatrics are both NHSC loan repayment eligible sites! PCHC offers loan repayment to those that are not awarded or eligible for NHSC. Competitive benefits package, 403(b) retirement, signing and retention bonuses, relocation assistance and more! Questions? Contact Vanessa Sanderson, PCHC Recruiter at (207)404-8015 or at recruitment@pchc.com.

5/27/19

Outpatient Internal Medicine Physician – Bangor, Maine

Northern Light Eastern Maine Medical Center seeks a primary care physician, board-certified/board-eligible in internal medicine, to join our well-established, quality-driven, outpatient practice.

Northern Light Eastern Maine Medical Center seeks a primary care physician, board-certified/board-eligible in internal medicine, to join our well-established, quality-driven, outpatient practice. Our practice is one of seven primary care practices operated by Northern Light Eastern Maine Medical Center. Our practice was the second in the nation to achieve “Patient-Centered Medical Home” status with NCQA. All physicians are NCQA-certified in diabetes and cardiac care. Our primary care network, largest in our area, has adopted a new practice model to include teams of one physician, one nurse practitioner, two registered nurses, and two medical assistants.

Northern Light Eastern Maine Medical Center is a 411-bed, regional, tertiary care and level II trauma center serving the more than 500,000 residents living in central, eastern, and northern Maine We offer a collegial atmosphere, cutting-edge EMR, generous vacation and CME benefit, flexible work schedule, and reasonable call schedule. No hospital call required. We also offer a relocation bonus and sign-on bonus in addition to our generous educational loan repayment program.

Candidates in need of J-1 visa waivers welcome to apply.

For confidential consideration, please contact:
Amanda Klausing, AASPR, Physician Recruiter
Northern Light Health
Phone: 207-973-5358
ProviderJobs@NorthernLight.org

5/27/19

Opportunities at the VA for Volunteer Physicians

Take advantage of this opportunity with the Veterans' Administration to thank our veterans in a concrete way for their service and their sacrifices.

The Physician Ambassador Program was created by the Department of Veterans Affairs as a best practice recruitment and placement initiative seeking fully licensed physicians and clinicians to enhance health care services for Veterans.

The Physician Ambassador Program is a without compensation program that provides civilian physicians and clinicians an opportunity to give back to the Veteran community by serving in a volunteer role to deliver health care services to Veterans. 

If you are interested in participating in this program at VA Maine Healthcare System, please contact Jonathan Barczyk at (207) 621-4886.

Volunteer Opportunity with Partners for World Health

Partners for World Health has a great need for advice from certain medical professionals on how to sort and package the vast amount of supplies received, for shipping and use in destination countries.

Volunteer Opportunity with Partners for World Health - Portland, ME

Partners for World Health (PWH) is a non-profit 501(c)3 based in Portland, Maine committed to reducing medical waste, improving the quality of healthcare in underserved countries, and educating our local community about global healthcare issues.

Our mission is to collect unused/discarded medical supplies from local medical facilities and to distribute those medical supplies to international communities in need. This work limits the negative impact we have on the environment and provides much-needed resources to the developing world. To support our work in improving health conditions around the world, we send local medical personnel on medical missions to developing countries, and we educate our local Maine community about global health issues. 

PWH has a great need for advice from certain medical professionals on how to sort and package the vast amount of supplies received, for shipping and use in destination countries, specifically, in the areas of:

• Surgery: all aspects of OR medical supplies and equipment
• Respiratory: any and all aspects
• Anesthesia
• Laparoscopic surgery: advice on the proper components of a “tower”
• Cardiology

Please note: this request is not for ongoing time commitment but rather for a few hours of a professional’s time to help organize certain supplies appropriately.

While PWH receives tens of thousands of pounds of equipment/supplies from hospitals and clinics, there are certain critical items always in short supply.

For more information, contact volunteer Rita Zanichkowsky at rznct@maine.rr.com or 207-232-3264, or contact Partners directly at 774-5555.  Thank you! 
https://www.partnersforworldhealth.org/