October 27, 2020

NEED TO KNOW

Information Blocking Rules Go Into Effect Nov. 2 – What Physicians Need to Know

Earlier this year, the Office of the National Coordinator for Health Information Technology (ONC) released regulations implementing provisions of the 21st Century Cures Act requiring physicians to comply with new regulations on the access, exchange, and use of patients’ electronic health information (EHI). Information blocking is a large focus of the new regulations and is defined as practices that prevent or materially discourage the access, exchange, or use of EHI. High-risk info blocking actions include interfering with:

• Patients who seek to access their own EHI (for example delaying patient access to lab results for a certain amount of time);
• Providers who seek EHI for treatment or quality improvement;
• Payers who seek EHI to confirm a clinical value; or
• Patient safety and public health.

For nearly all EHI requests, physicians must respond and release patients’ medical records unless an appropriate exception can be identified and used. Currently, physicians and other “actors” are required to comply with ONC’s information blocking regulations by November 2, 2020. While the AMA expects a delay of enforcement of the new rule, practices should education themselves about what the rule requires. The AMA has created a two-part educational resource to help physicians and their medical practices understand the requirements and develop an information blocking compliance program.

Part 1: What is Information Blocking

Part 2: How do I comply with Information Blocking and where do I start?

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Vermont Medicaid, Department of Financial Regulation Release Draft Recommendations for Audio-Only Reimbursement

Late last week, Vermont Medicaid (DVHA) and the Department of Financial Regulation both released draft recommendations regarding reimbursement for audio-only telehealth services after the end of the COVID-19 public health emergency. Vermont Medicaid has proposed continued coverage of health care services delivered by telephone when medically necessary, clinically appropriate, and when access to face-to-face or two-way, real-time, live audio and video interactive communication is unavailable. Similarly, the Department of Financial Regulation has proposed requiring commercial health insurers to continue coverage of audio-only telephone services when medically necessary and clinically appropriate. DFR has further recommended that fee for service reimbursement be time-limited and eventually be incorporated into value-based payment models. Both payers have suggested providers must complete appropriate training for delivering services through telehealth and VMS is advocating to adjust this requirement to take into account clinicians who are already experienced offering telehealth services. These recommendations will go to the legislature for consideration this session. To request copies of the draft recommendations or to submit feedback, please contact jbarnard@vtmd.org 

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Vermont Health Department Submits COVID Vaccination Plan to the CDC

Last week, the Vermont Department of Health (VDH) submitted a preliminary plan on how the State will administer COVID vaccinations once a vaccine has been approved and is ready for distribution. Chris Finley, the Immunization Program Director at VDH, said the first priority for the vaccination will be health care workers, specifically those delivering direct care. The State plan proposes partnering with hospitals to not only ensure their own staff gets a COVID vaccine, but also for the hospitals to provide the vaccination to the other health care workers in each Hospital Service Area (HSA). The State has created a COVID Vaccination Advisory Committee in order to determine an equitable distribution methodology when a viable vaccine becomes available. Click to learn more about the COVID Vaccination Plan.

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Today the UVM Medical Center and the Vaccine Testing Center at UVM Larner College of Medicine announced that they have been selected to participate in a Phase 3 trial for a COVID-19 vaccine developed by Oxford University and manufactured by AstraZeneca. This is a two-year trial that will include at least 250 people from our region and about 30,000 nationwide. For more information about this vaccine trial, you can visit UVMHealth.org/COVIDStudy. UVMNH is also hosting an information session for the general public on Monday, November 2nd from 5:30-6:45 p.m.; more information is available here.

Commissioner Call Update

VMS weekly calls with Vermont Department of Health Commissioner, Mark Levine, M.D. are held each Thursday from 12:30-1:00 p.m. on ZOOM - click below for the virtual meeting address that will remain constant each week. 

Once a month, VMS will feature a guest speaker during this call time, as the Commissioner has a conflict. The speaker will discuss clinical protocols and best practices during the State of Emergency.

Join Zoom Meeting -https://us02web.zoom.us/j/86726253105?pwd=VkVuNTJ1ZFQ2R3diSVdqdlJ2ZG4yQT09

Meeting ID: 867 2625 3105 / Password: 540684

Dial In: 1 646 876 9923 / Meeting ID: 867 2625 3105 / Password: 540684

MISC.

Invalid National Drug Code for the 2020-2021 Flu Season

National Government Services (NGS) has noticed many claims being billed for the 2020-2021 flu season are using incorrect current procedural terminology (CPT) codes for influenza flu vaccines. The national drug codes (NDCs) change each influenza season. The correct NDC and Healthcare Common Procedure Coding System (HCPCS) code are necessary or your claim will be denied. Please review and use the appropriate flu vaccine code to avoid processing delays and claim denials on the CMS Seasonal Influenza Vaccines Pricing web page.

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Need CME Credits for Relicensure?

Vermont-licensed physicians must renew their licenses and attest to completing 15 hours of CME credit by November 30, 2020, including one hour on hospice/palliative care/pain management and two hours on prescribing controlled substances. Need some ideas for how to meet these requirements? The Vermont Academic Detailing program is a university-based prescriber education and support program.  All sessions are free and are currently being offered over Zoom. A new topic is now available on Managing "Headline Stress" In The Setting of COVID-19. Other topics on Fibromyalgia, Management of Opioids and Advanced Management of Opioids meet an hour of the Vermont prescribing controlled substances requirement. VMS also has a list of other sources of free and low cost CME and don’t forget the VMS annual meeting educational sessions coming up November 7th!

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E/M Office Visit Changes Effective Jan 2021

Effective January 1, 2021, CMS has adopted major modifications to coding, documentation, and payment of evaluation and management (E/M) services for office visit CPT codes (99201-99215). This includes the elimination of code 99201. We encourage you to read about the changes and what they mean for your practice. The American Medical Association (AMA) has developed an extensive online library of resources to assist with the transition, which includes the following titles:

• Implementing CPT® Evaluation and Management (E/M) revisions page
• CPT Evaluation and Management Overview Page (see “Essential Tools and Resources” at the bottom of page)
• 10 Tips to Prepare your Practice for E/M Office Visit Changes

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2021 Medicare Open Enrollment Is Open

Last week, CMS announced that 2021 Medicare Open Enrollment is officially open and will run through December 7, 2020. More than 60 million people with Medicare can review health and drug plans, and make changes to their healthcare coverage for next year, based on their financial and medical needs. Counseling on Medicare options is available through the nonprofit State Health Insurance Assistance Program or calling 1-800-MEDICARE (1-800-633-4227).

EVENTS

New Webinar on E/M Coding Changes: What Will Happen to the Physician Note?

Wed., Oct 28, 2020 11:30 AM - 12:30 PM

Dr. Barbara Levy, a member of AMA’s CPT® Editorial Panel, and Dr. Craig Joseph, Nordic’s Chief Medical Officer, will discuss how physician organizations can maximize physician satisfaction and improve clinical documentation while adhering to the E/M rules effective in 2021. The panelists will also cover the high-level 2021 E/M modifications. Register here.

VMS November Webinar: Let’s Take a Moment for YOUR Wellness!

Please join us on Thursday, November 19, 2020 from 12:00 pm to 1:00 pm for our VMS November webinar. During this noontime wellness focused webinar, speakers Joe Lasek, M.D., and Doug Wysockey-Johson, M.Div., local leading experts on mental health and wellness will be exploring the value and strategies behind maintaining wellness as a medical professional. To register click here. To see the entire VMS Thursday Webinar series for 2020/2021 click here. 

Osteoporosis Update for Primary Care

Friday, November 6, 2020

7:30 a.m. - 12:45 p.m.

This half-day virtual conference features course Director Jennifer Kelly, DO and other UVM Health Network faculty, who will present on topics designed to improve the skills of the primary care team when they encounter patients who have, or who are at risk of developing, osteoporosis. Register. See the full 2020/2021 Continuing Medical Education schedule here. 

Seeking Palliative Care CME credits for relicensure? VEN's Fall Palliative Care VIRTUAL Conference, "Informed Consent: More Than A Piece of Paper"

Monday, Nov. 9, 2020

8:15 a.m. - 4:15pm EST

Unpacking the ethical, legal and practical considerations of obtaining informed consent in complex clinical situations and at end-of-life with plenary talks by Thaddeus Mason Pope, JD, PhD and Guy Matal, MD. Click to register here

RME Collaborative’s 2020 Rural Health Clinical Congress

Saturday, Nov. 21, 2020

9 a.m. EST

An interactive, multi-topic, complimentary CME/CE conference held in conjunction with National Rural Health Day, designed for primary care providers who care for patients in rural and underserved areas. Click here to learn more and register 

Vermont Medical Society

134 Main Street

PO Box 1457

Montpelier, VT 05601

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