News to Use
AUGUSTA - The people's veto petition effort to repeal Public Law 154 (LD 798) "An Act To Protect Maine Children and Students from Preventable Diseases by Repealing Certain Exemptions from the Laws Governing Immunization Requirements," has submitted the required number of valid signatures to qualify for the 2020 statewide referendum ballot, Secretary of State Matthew Dunlap confirmed today.
Proponents submitted 29,370 petitions with 95,871 signatures to the Elections Division on Wednesday, Sept. 18, 2019. Staff members at the Bureau of Corporations, Elections and Commissions have completed the process of certifying the petitions and have found 79,056 valid signatures of registered Maine voters, while 16,815 are not valid.
State law requires a minimum of 63,067 valid signatures, which is 10% of the total votes cast in the last gubernatorial election, for a successful peoples veto effort. As the effort has exceeded that threshold, the petition effort is deemed valid. The determination will be sent to Gov. Janet Mills to issue a proclamation declaring a public vote on the issue.
The vote must take place at the next statewide election that is not less than 60 days after the proclamation, which will be the March 3, 2020 presidential primary.
In Memoriam: Douglas Lee Wood, DO, PhD, former dean of UNE COM and president of AACOM
Douglas Lee Wood, DO, PhD, former dean of Michigan State University College of Osteopathic Medicine (MSUCOM), and the University of New England, College of Osteopathic Medicine (UNE COM) as well as the president of the American Association of Colleges of Osteopathic Medicine (AACOM), passed away on Oct. 6, 2019, at his home in Annapolis, Maryland, surrounded by his family.
Dr. Wood was born on Nov. 20, 1938, in Muskegon, Michigan. He graduated from the University of Michigan and attended medical school at what is now the Kansas City University of Medicine and Biosciences College of Osteopathic Medicine.
After a lengthy tenure as a nephrologist and director of medicine at Mt. Clemens General Hospital, Dr. Wood developed, planned and ultimately opened a dialysis unit at the hospital. Dr. Wood left his practice to pursue his true passion: medical education. He obtained a PhD from Wayne State University and became the dean of MSUCOM. From there, he became the president of AACOM.
While in the position of president of AACOM, Dr. Wood had the opportunity to foster the development of multiple medical schools throughout the country. He was a great innovator and changed the face of medical education. Dr. Wood touched the lives of many students. While he loved working to make changes in how to teach medical students, what he loved most was spending time with his students.
Dr. Wood leaves behind his beloved wife, Janet, his four children, one sister, many grandchildren and one great-grandchild. Dr. Wood will always be remembered as an amazing husband, father, brother, grandfather, great-grandfather, physician and innovator.
Read his full obituary here.
AOA Announces online OB-GYN continuous certification launching in November
The American Osteopathic Board of Obstetrics & Gynecology (AOBOG) is launching a new online exam process for Osteopathic Continuous Certification Component 3. This new format delivers cognitive assessment questions that are relevant to OB/GYN scope of practice at prescribed intervals.
This format is an enhancement over the traditional high-stakes recertification exam offered every six years. It provides greater flexibility and targeted content on a web-based platform.
By leveraging technology to improve the way Component 3 is delivered, the AOA is providing high-quality, user-friendly ongoing assessment to support lifelong learning.
Details on AOBOG’s online continuous certification platform are available here. Please share news of this fresh innovation with OB/GYN residents and board-certified physicians.
AOA submits comments on Executive Order impacting Medicare, physician payment
On October 3, the White House released an Executive Order that calls for a number of regulatory changes that would impact both traditional Medicare Fee-For-Service and Medicare Advantage plans. A few of the proposals are promising. Others require careful attention and are potentially concerning.
One issue of concern is over regulations that would allow for payment parity for physicians and non-physicians, paying for services and not based on a clinician’s occupation. The Executive Order requires federal agencies to draft new regulations over the next six months; the AOA will review and comment on them when released.
In the meantime, the AOA submitted this letter to President Trump commenting on the Executive Order and also shared it with senior Health and Human Services staff.
Public Health Updates
Juul Suspends Sales of Flavored Vapes And Signs Settlement To Stop Marketing To Youth
NPR, October 17, 20196:34 PM ET, Allison Aubrey
E-cigarette maker Juul Labs announced Thursday it will suspend sales of most of its flavored products, including mango, fruit and cucumber. These types of flavors are considered an on-ramp to vaping for teenagers. The move comes as the industry faces immense scrutiny. Several states have instituted bans on flavored products, and the Trump administration has signaled that a federal ban may be in the works. At a time when 25% of high school seniors surveyed in the U.S. say they've vaped within the last 30 days, the company is also under pressure to limit marketing and advertising to youth.
Juul's move to suspend flavors comes the same day that a small non-profit group, Center for Environmental Health, announced a legally-binding agreement of its lawsuit with the company that will limit Juul's marketing to kids and teens in specific ways. For instance, Juul cannot advertise at sporting events or concerts that allow people under the age 21. The company may not pay for or permit company employees to appear at schools. And, the company can't use models in their ads that are under the age of 28. The settlement is enforceable only in California — and only for a finite period. Public health experts say it's a step in the right direction, but more action from federal regulators is needed to rein in the epidemic of teen vaping.
Read More Here.
Maine CDC Advisory on E-Cigarettes and Pulmonary Disease
The Maine CDC issued a Health Advisory on October 3rd to inform clinicians that pursuant to 22 M.R.S. 802(1)(B), pulmonary disease associated with e-cigarette use is now temporarily added to the list of Notifiable Conditions that are required to be reported to Maine CDC. Link to full advisory here. There is now a Webpage dedicated to the Pulmonary Illness Investigation.
Summary: There has been an increase in the number of cases of significant lung illness related to e-cigarette use in Maine. As of Wednesday, October 2, four additional cases of lung illness related to e-cigarette use have been confirmed, bringing Maine's total to five cases. No deaths from this illness have been reported in Maine.
Recommendations: Consider e-cigarette-associated illness with patients who present with respiratory illness of unclear etiology and who have vaped or dabbed within the past 90 days. Clinicians should ask about and document extent of use, type of instrument used, type of vaping liquid used (i.e. nicotine, THC), place of purchase, and if the patient still has the vaping liquid they used. Clinicians should also complete a respiratory viral panel and test for influenza to rule out a possible viral cause of illness.
Reporting: Clinicians should report cases with onset on or after May 1, 2019, that meet the criteria of (1) significant respiratory illness of unclear etiology and (2) a history of vaping. All suspect cases should be reported by phone to Maine CDCs 24/7 disease reporting and consultation line at 1-800-821-5821 or by fax to 1-800-293-7534 using the Disease Reporting Form.
Attention: On October 9, 2019, Maine CDC hosted a live webinar to discuss pulmonary illness associated with e-cigarette use. When available, a recording of this webinar will be distributed.
MaineCare Adds Buprenorphine/Naloxone Tablets to Preferred List
[Thanks to the Maine Hospital Association]
MaineCare, Maine's Medicaid system, has added generic buprenorphine/naloxone tablets to its list of preferred medications on its Preferred Drug List. They join Suboxone film, which remains on the list.
Other forms of buprenorphine, including probuphine, sublocade, and zubsolve, remain subject to prior authorization requirements. Criteria may be found on MaineCare's Preferred Drug list, at http://mainecarepdl.org/pdl .
CMS Physician Self-Referral "Stark Rule"
On October 9, CMS issued a proposed rule to modernize and clarify the regulations that interpret the Medicare physician self-referral law (often called the “Stark Law”), which has not been significantly updated since it was enacted in 1989. The proposed rule supports the CMS “Patients over Paperwork” initiative by reducing unnecessary regulatory burden on physicians and other health care providers while reinforcing the Stark Law’s goal of protecting patients from unnecessary services and being steered to less convenient, lower quality, or more expensive services because of a physician’s financial self-interest. Through the Patients over Paperwork initiative, the proposed rule opens additional avenues for physicians and other health care providers to coordinate the care of the patients they serve – allowing providers across different health care settings to work together to ensure patients receive the highest quality of care.
For More information:
CMS 2020 Proposed Physician Fee Schedule-- Update from AOA
Each year, the Centers for Medicare & Medicaid Services (CMS) releases proposed changes to the Medicare program; including, but not limited to, how physicians are reimbursed through Medicare. This proposal is called the Medicare Physician Fee Schedule proposed rule or PFS for short. CMS gives the public the opportunity to comment on the proposed changes before a final rule is released. Typically the comment period is open for 60 days, and after the period closes CMS then considers the comments that were posted. These rules can often be lengthy and complicated; the 2020 Medicare PFS proposed rule is over 800 pages. That’s where the AOA comes in. We carefully analyze the rules and make public comments to CMS on how it would impact the osteopathic physicians.
Overall, the AOA is generally supportive of many of the changes CMS is proposing for 2020 but identified several areas for improvement and opportunity. You can read our entire comment letter here but if you’re in a hurry, let’s take a quick look at the highlights of the 2020 Medicare PFS proposed rule. Contact Sean Neal at firstname.lastname@example.org if you have any comments or suggestions.
Maine Practitioner Diversion Awareness Training (MEPDAT) -- November 6, 2019 in Augusta
The Maine Practitioner Diversion Awareness Training (MEPDAT) will be held on Wednesday November 6, 2019 at the Augusta Civic Center, 76 Community Drive Augusta, Maine 04330. The program is free for DEA Registrants and registration can be to attend in-person or for a livestream feed. This free training offers 6.0 AMA PRA Category 1 Credits ™. The program also meets the Maine Board of Licensure's 3 hours of Continuing Medical Education requirement on the prescribing of opioid medication.
Link to the AGENDA.
REGISTER HERE for In-Person Option.
Live-Stream Option Register HERE.
MOA Members Experiencing Frequent OMT/Mod-25 Denials
The Maine Osteopathic Association’s Medical Economics Committee (formerly Payor/Payee Committee) has received a number of recent calls and emails from members regarding concerns about osteopathic manipulative treatment (OMT) payment policy.
Complaints have largely focused on the issue of Evaluation/ Management codes billed on the same date of service with OMT codes using Modifier 25. Anthem & Aetna have announced new clinical validation policies which are believed to be one cause of the large volume of denials members are experiencing. The MOA has secured contacts and held meetings with carriers including Harvard Pilgrim, Anthem & Aetna to discuss these denials on behalf of our members and to share information about standard OMT coding conventions. Many of these conversations are ongoing (meetings with Anthem and Aetna in particular have been held in the last 30 days and follow-ups are in the process of being scheduled). We urge members to reach out to the MOA office at 207-623-1101 for details on these issues and for more detailed information.
The AOA is also actively involved in conversations with Anthem about their new clinical validation policy, which affects claims appended with modifiers 25, 57, and 59. For more detail on that policy, see that AOA's statement here.
We know that members are concerned about the volume of denials they are receiving. We are actively educating and advocating for fair and appropriate reimbursement. We are making slow progress.
We encourage members to review all denied claims. Be sure to follow instructions regarding re-submitting the claim and providing documentation upon appeal. We would also remind you to keep detailed records. We understand that these changes in payment policy create additional administrative burdens and can also negatively impact patient care.
The MOA Medical Economic Committee, co-chaired by Stephanie Collins, DO & Kiran Mangalam, DO continues to engage in our meetings with insurers and expects to meet & develop an action plan to further involve concerned members in the coming weeks. If you have concerns about medical claims being denied, feel free to complete the MOA Hassle Factor Form and/or call the MOA office at 207-623-1101. This information helps us to track trends and changes in payment policy.
AOA Members: You can also contact the AOA Physician Services team for assistance by email at email@example.com
Did you know that MOA offers online CME Programs?
Please find MOA on-demand CME programs at our new CE21 site:
308 Osteopathic CME Programs are now available via this site!
SAVE THE DATE FOR 2020 CME EVENTS:
MOA Midwinter Symposium
Holiday Inn by the Bay, Portland, ME
February 7-9th, 2020
Draft Agenda & Registration Details Available soon!
109th Annual Convention
The Samoset Resort, Rockport, ME
June 5-7th, 2020
Upcoming webinars for opioid prescribing credit (FREE! And covers ME requirement):
Tuesday, November 19, 2019, at 12pm
Co-Prescribing Benzodiazepines and Opioids: The Black Box of Increased Overdose Risk
Presenter: Elisabeth Fowlie Mock, MD, MPH
Another option for Opioid CME credit:
MICIS Academic Detailing Sessions (1 Hour Sessions)-- FREE, With CME Credit Offered
Academic detailing is peer-to-peer educational outreach which is designed to improve prescribing practices. It is useful for improving quality of care and identifying priorities for change.
Prescribers (MD, DO, PA, NP) and Medical Directors may request an individual Academic Detailing session at their practice location. This direct learning session will be lead by Elisabeth Fowlie Mock, MD, MPH, an experienced clinician, teacher and leader in the opioid crisis and an Academic Detailer with MICIS since 2011. There is no charge for this session.
This service is directed to two groups of prescribers: those who have complex patients with chronic pain on opioids and those who are considering providing buprenorphine treatment for opioid use disorder. Sessions can be scheduled for any time of day, cover one hour of content, and multiple sessions for providers in the same or nearby practices can be scheduled on the same day. Participants will be able to prioritize their learning needs and customize the learning session.
Contact MICIS to schedule an Academic Detailing session. More information can be found here.
Integrated Structural Acupuncture Course for Physicians
The Integrated Structural Acupuncture Course for Physicians features hands-on training on real patients by world renowned master, Kiiko Matsumoto, and other recognized experts in acupuncture. Learn how to integrate acupuncture into your busy medical practice.
The course runs September 23, 2019 - June 8, 2020 at the AC Hotel by Marriott Boston Cambridge in Cambridge, MA. Unique access to web-based learning with 4 live weekend sessions in the beautiful and historic Boston, Massachusetts.
300+ AMA PRA Category 1 Credits TM and AOA Hours
In the course, you will learn how to:
Combat the opioid crisis and develop skills to offer patients effective alternative treatments, Become an expert in dry needling, Incorporate basic osteopathic methods of assessment and treatment into your practice, Acquire techniques for rapid treatment of emergency medical conditions, Acupuncture practice management
Help your patients effectively manage a variety of complex problems including Pain, OB/GYN, Hormonal, GI, Cardiovascular, Neurological and Psychiatric, Structural and Orthopedic, Autoimmune and Autonomic, etc.
Learn a variety of treatment strategies and acupuncture techniques, including Ear Acupuncture, Scar Treatment, Myofascial and Neuroanatomic Treatments, Dry Needling, Electroacupuncture and Laser techniques, Osteopathic Assessment, Nutritional Integration , Cosmetic Acupuncture and more!
For more info visit us today at www.AcuMed.org.
Learn more about the course details or print a course schedule.
AC Hotel By Marriott Boston Cambridge
Sponsored by AcuMed and the UNE College of Osteopathic Medicine
Maine Concussion Management Initiative Will Be Offering Training Programs – 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. 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 firstname.lastname@example.org or 207-577-2018.
14th Annual University of Maine Geriatrics Colloquium: Innovations in Dementia Care
Click here to register for the Geriatrics Colloquium on Monday, October 28, 2019.
Want to learn more? Click here to view the program of the day, and click here to visit our webpage with a link to register as a sponsor, exhibitor, or participant.
Northern New England Society of Addiction Medicine 2019 Conference:November 8 & 9, 2019 in Wolfeboro, NH
Registration & Brochure: https://nnesam.org
Obesity Medicine: There is no 'one size fits all' - Monthly Lecture Series -- November 13th
What: Monthly Lecture Series (1.25 AMA PRA category one CME credits per lecture for 12 months for a total of 15 CME credits)
When: Lecture #1- November 13th, from 6:00pm - 7:15pm
Where: 66 Leighton Rd, Falmouth, ME 04105
Who: Catherine Krouse, DO
Why: Obesity continues to skyrocket and most patients are not getting the help they desperately need. Join us and learn the science behind obesity and current clinical guidelines in treating it. Understanding the physiology of weight regulation will help open lines of communication with your patients in unexpected ways, and help guide patients towards treatment options with the best evidence for long term success.
COST: $40 per lecture OR $360 for the entire series (15 CME)
Osteopathic Cranial Academy CME Offerings
November 8-10, 2019
Visual Somatic Dysfunction – Diagnosis and Management
Course Director: Paul Dart MD FCA
February 15-19, 2020 Midwinter Introductory Course in
Osteopathy in the Cranial Field
Course Director: Zina Pelkey DO FCA
Associate Director: Therese M. Scott DO
Hilton Norfolk The Main
The Osteopathic Cranial Academy
3535 E. 96th Street, Suite 101 Indianapolis, IN 46240
(317) 581-0411 FAX: (317) 580-9299
Web site: www.cranialacademy.org
Healthcare Quality and Safety 2019 Conference - The Conference for Professionals Who Plan, Manage or Support Quality and Safety Initiatives
November 6 – 7th, 2019
Wyndham Boston Beacon Hill Hotel, Boston, MA
To learn more about this event, visit our website: http://quality.bwh.harvard.edu/
Photo credit: D. Halbach
Location: DoubleTree by Hilton Portland - 363 Maine Mall Rd, So. Portland, ME 04106
28th Annual Family Medicine Update & Annual Meeting ~ April 1-4, 2020
- April 1st – 1-5pm - KSA Study Group
- April 2nd & 3rd – 8am – 5pm each day 28th Annual Family Medicine Update CME sessions
- Annual Business Meeting
- April 4th – (Tentative) Opioid Education Session – FREE to MAFP Members!
- (meets Maine Licensure CME requirements)
Full brochure & registration information available after January 15, 2020
Need a Change of Scenery? Find Osteopathic CME Live Programs All Over the US!
Download NOW! Android Users: Google Play Store Apple Users: Apple Store
Classified Ads & Job Postings
Maine DHHS Office of Child & Family Services (OCFS) Medical Director Opportunity: The Maine Office of Child & Family Services (OCFS) is looking to identify a new Medical Director and is eager to identify qualified physicians, nurse practitioners, or physician assistants who are interested in applying for the position.
The OCFS Medical Director is responsible for providing clinical leadership, strategic policy direction, technical assistance, and clinical support for OCFS program and staff, and supports OCFS goals and objectives established in coordination with the OCFS Director and the Commissioner’s Office of DHHS. The Medical Director supports development and implementation of policy that aims to improve health outcomes for Maine children and families by improving both their experience of care and population health outcomes. The Medical Director will provide consultation and technical assistance to OCFS staff and community-based providers; participate in relevant advisory groups; and when needed, interact with state legislature and legislative committees at the direction of OCFS leadership. The position is expected to be 0.8-1.0 FTE and is based in Augusta.
Qualified applicants are encouraged to contact Dr Lisa Letourneau at email@example.com with any questions, along with their resume.
MaineCare Medical Director Opportunity: The Office of MaineCare Services (OMS) is continuing its search for a new MaineCare Medical Director and is eager to identify qualified physicians, nurse practitioners, or physician assistants who are interested in applying for the position. More information & position qualifications are included in the attached position description, but in brief…
The Office of MaineCare Services is seeking qualified candidates for the position of MaineCare Medical Director. The Medical Director is responsible for providing clinical leadership and policy direction and oversight to the MaineCare program and staff and supports MaineCare goals and objectives established in coordination with the MaineCare Director and the Commissioner’s Office of Dept of Health & Human Services (DHHS). The Medical Director supports development and implementation of policy that aims to improve health outcomes for Medicaid beneficiaries by improving population health outcomes and member experience and promotes the cost-effective use of resources. The Medical Director directly communicates with healthcare providers in the state, participates in relevant advisory groups, and when needed, interacts with state legislature and legislative committees at the direction of MaineCare leadership. The position is expected to be 0.8-1.0 FTE and is based in Augusta.
Qualified applicants are encouraged to contact Dr Lisa Letourneau at firstname.lastname@example.org with any questions, along with their resume.
MOA Members--Save $$ On a Phillips HeartStart Defibrillator
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Maine Osteopathic Association, PO Box 315, Manchester, ME 04351
www.mainedo.org | P. 207.623.1101 | F. 207.623.4228