November 10, 2020


207th VMS Annual Meeting and First Virtual Meeting Celebrates Health Care Heroes

From the start to the finish the 207th Annual VMS Meeting was a testament to the dedication of Vermont clinicians to their practice and to the deep connection VMS members have with each other. VMS’ first virtual meeting, hosted in collaboration with the American Academy of Pediatrics Vermont Chapter, the Vermont Academy of Family Physicians and the Vermont Psychiatric Association, was a huge success. The meeting saw high participation, engaging speakers Zooming in from around the country and inspiring award winners. The true test of the virtual platform was the VMS Business Meeting, which this year was tasked with debating and voting on two policy resolutions. But with VMS Immediate Past President Cathy Schneider, M.D., moderating and former VMS President John Leppman, M.D., as parliamentarian, everyone’s voice was heard and the membership voted in support of both policy resolutions focused on establishing VMS’ position on state-based and national health reform. Click here for the final language of the resolutions. The Awards Brunch honored ten awardees this year. VMS members also elected a new slate of Society officers including: as VMS President, Simha Ravven, MD (Psychiatry, Howard Center); as President-Elect, Patricia Fisher, MD (Family Medicine, CVMC); and as Vice President, Ryan Sexton, MD (Emergency Medicine, NVRH). Our afternoon CME sessions were kicked off by welcoming remarks from AMA President, Susan R. Bailey, MD, with the educational sessions focused on health equity amidst the COVID-19 pandemic. Watch your email for a Green Mountain Physician edition dedicated to the meeting, including award winners, adopted policies, recordings of the CME sessions, photos and more highlights from the day. Thank you to everyone who has worked tirelessly through this pandemic and to those who contributed to the massive success of this meeting!


Travel Map Suspended; Vermont Implements Universal Quarantine Policy, Ramps Up Testing

With COVID-19 cases spiking across the nation and regionally, and based on the dwindling number of counties that would qualify as safe for travel outside Vermont, the State of Vermont has suspended the use of the Department of Financial Regulation (DFR) Travel map and implemented a mandatory quarantine policy for anyone returning or traveling to Vermont. Commissioner of Health, Dr. Mark Levine, said in today’s press conference that with the holidays approaching and the increasing number of virus cases in our immediate region, “we have an opportunity to stop the sea of red (COVID-19 infection rates) we see outside our state from overtaking Vermont.” Commissioner Levine also said due to the increased rate of COVID-19 activity in Vermont, VDH is going to increase surveillance testing and has broadened the testing recommendations.  Within the next week or two, additional testing locations and testing for teachers and school staff through self-administered nasal swabs will be available 7 days/week through a contract with CIC Health out of Cambridge, Mass.

 These are the updated recommendations for patients who should seek testing:

  • Near and Close Contacts for households, worksites, and events where there is a case ask all individuals to be tested immediately in addition to at 7 days (previously, contacts were not advised to get tested immediately)
  • Index Case: individuals who were in contact (not close contacts) of a case within the 14 day period prior to them being a case
  • Gatherings: Anyone who plans to participate in a gathering; or Anyone who has attended a social or mass gathering
  • Travel: Anyone traveling out of state (not just testing if you want to get out of quarantine); or Anyone who has a visitor from out of state in their home; or College students returning to Vermont
  • Social Activity: If socially active, seek a test weekly.

VPQHC Provides 63 Practices With Telehealth Equipment

Last week, Seema Kumar, the Program Manager for the Vermont Program for Quality Health Care’s (VPQHC) Connectivity Care Packages Pilot Program (CCP), provided a status update on the grant program using federal Coronavirus Relief Funds (CRF) in order to provide Vermont practices with equipment and education to help their patients better access telehealth services. Seema reported that approximately 63 health care facilities will be receiving 1,000 ipads and 350 wi-fi boosters and that this equipment will be delivered no later than Nov. 20, 2020. The quick turn-around on the pilot is in part due to the deadline on the federal CRF funds, which must be spent by December 30, 2020. Click here to learn more about the progress of the CCP program and to see the participating practices.  For practices interested in more information or in participating in the program you can send a message directly to Seema through this form:


Joint Fiscal Committee Delays Vote to Reallocate $81 Million from the Health Care Provider Stabilization Grant Program

The Joint Fiscal Committee delayed action this past Monday on a request from the Scott Administration to reallocate approximately $81 million in Coronavirus Relief Funds (CRF) primarily from the Health Care Provider Stabilization Grant Program to help businesses recover from pandemic-related expenses. The Agency of Human Services (AHS) presented the request to the Joint Fiscal Committee on Thursday, November 5th and said that they have carefully calculated the need of health care providers after a second round of grant applications and anticipate approximately $81 million will be left in the fund. Sarah Clark, Deputy Commissioner of the Department of Finance, reported that $87 million was spent in the first round of Provider Stabilization grants and said there is currently about $78 million for the second round of funding available. She said there are two reasons the full $247 million originally appropriated will not be spent: they didn’t know how much federal assistance was going to be available to providers and they did not know how health care utilization was going to rebound throughout the summer. The grant program only covers expenses and losses due to COVID-19 up to September 15th, 2020. House Health Care Chair Bill Lippert, D-Hinesburg, asked why they aren’t considering a third round of Stabilization grants, to which AHS responded that there is not enough time to stand-up the program before the federal December 30th, 2020 deadline for using the funds and that they are anticipating there will be another federal stimulus package to cover possible surge expenses through the fall and early winter. The Joint Fiscal Committee only has 10 days to decide on the Scott Administration’s request and reportedly will meet this Saturday to decide.

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 -

Meeting ID: 867 2625 3105 / Password: 540684

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


Medicaid Proposes 2021 Physician Fee Schedule – Open for Comments

Vermont Medicaid released its proposed 2021 Resource-Based Relative Value Scale (RBRVS) fee schedule. The payments are being updated to align with Medicare’s 2020 relative value units (RVUs), and the primary care conversion factor is increasing from $36.04 to $36.09. This keeps the primary care conversation factor at 100% of Medicare rates, however when taking into account decreases in other elements of the Medicare payment formula (Geographic Indices for Practice Expense and Malpractice) this does result in a net .2% decease in reimbursement for all codes and a .5% decrease for primary care physicians (about $200,000). The changes are proposed to go into effect 1/1/21 and last until 7/1/21, when the fee schedule will be updated again. A summary of the changes can be found here. Please send comments or feedback to


Please Respond – Seeking Feedback on Appointment Wait Times

The Scott Administration and Department of Financial Regulation (DFR) have received anecdotal reports that some patients are seeing delayed wait times for medical appointments, especially specialty care. DFR would like to better understand if wait times are longer than normal or are being exacerbated due to COVID-19 restrictions. Please take a moment to fill out this brief survey, that should take no more than 2-3 minutes to complete. 


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:


      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. 

      Someone You Love: The HPV Epidemic Documentary

      Tue, November 17, 2020

      7:30 AM – 9:30 AM EST

      Earn 2.0 CME Credits for participating in this showing of the HPV Documentary, "Someone You Love." This event is sponsored by Bi-State Primary Care Association, the Norris Cotton Cancer Center, the American Cancer Society, Southern NH Area Health Education Center, and the Vermont Department of Health. 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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