February 16, 2021

NEED TO KNOW

This Week's VMS 2021 Advocacy Month Action: Race and Health Equity Webinar

In honor of Black History Month, please join the VMS this Thursday, February 18, 2020 from 12:00 pm to 1:00 pm for our VMS February webinar on "Race and Health Equity." Please join Dr. Becca Bell, President of the American Academy of Pediatrics Vermont Chapter, for a discussion on the task force created by the AAP Vermont Chapter on race and health equity. The task force has focused onguidance and resources for practices working towards creating a culturally safe medical home and promoting anti-racism and for families experiencing racism. This session will discuss AAP-VT’s process to support pediatricians, families and other child health providers. To register click here. To see the entire VMS Thursday Webinar series for 2020/2021 click here.  Note: This webinar will take place at the same time VMS is hosting our scheduled Commissioner Call.

This webinar is the third action in the VMS' 2021 Advocacy Month and we want to thank everyone who was able to participate in last week's VMS Virtual Advocacy Training. The advocacy training was well-attended and focused on crafting and delivering your own advocacy message. We were joined by Vermont's legislative leaders: Senate President Pro Tem Becca BalintHouse Speaker Jill KrowinskiSenate Minority Leader Randy Brock and House Minority Leader Patti McCoy and then all took part in a peer-led workshop using real-life 2021 legislative proposals to form our policy "asks." Click here for the 2021 VMS Advocacy Toolkit for simple tools to help you craft cogent, effective communications and go here to see all of the VMS 2021 Advocacy Month actions. 

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Action Alert: Please Make Physician Scholarships a Budget Priority this Legislative Session

This Friday is the deadline for the House Health Care Committee to make recommendations to the House Appropriations Committee on the top health care initiatives that should be included in this year's FY22 Budget. Today, VMS Executive Director Jessa Barnard is testifying to urge the Committee to prioritize the Primary Care Physician Scholarship program to receive on-going funding, as this is a critical step in addressing Vermont's primary care workforce shortage. Please email the Committee to let them know that the ongoing funding of these scholarships will result, at a very minimum, in 10 more primary care physicians practicing in Vermont at any given time, which will have a considerable impact on the health and wellbeing of Vermonters in rural areas of the state. Please click here to read VMS' testimony. 

House Health Care Committee members’ email addresses:  

wlippert@leg.state.vt.usadonahue@leg.state.vt.usLHoughton@leg.state.vt.us

ablack@leg.state.vt.useburrows@leg.state.vt.usbcina@leg.state.vt.us 

mcordes@leg.state.vt.uslgoldman@leg.state.vt.uselong@leg.state.vt.us

wpage@leg.state.vt.usapeterson@leg.state.vt.us


Other VMS Policy Priorities being considered this week include: 

  • S.22, a bill regarding health care practitioners administering stem cell products not approved by the U.S. Food and Drug Administration, will be heard in the Senate Health and Welfare Committee this Friday and Jessa Barnard will testify in support;
  • S.24, the bill to prohibit the sales of flavored tobacco, will have a comprehensive hearing in the Senate Health and Welfare Committee and a supporting press conference on Wednesday, Feb. 17th. VMS and AAP VT member, L.E. Faricy, M.D., will testify;
  • S.25, a bill making changes to the cannabis commercialization bill that was passed in 2020, was heard in the Senate Judiciary Committee this morning. The Committee is working on language to ensure that the 30% of excise tax revenue allocated to prevention is directed to substance misuse prevention activities and to clarify restrictions on advertising in statute;
  • H.210, a bill to create a Vermont State Office of Health Equity and to require Continuing Medical Education focused on cultural competency will be heard in the House Health Care Committee;
  • COVID-19 emergency flexibilities, legislation to extend regulatory flexibilities that are set to end March 31, 2021, is being considered by the Senate Health and Welfare Committee. The current proposal would extend most regulatory flexibilities, such as those licensing out-of-state health care professionals, until March 31, 2022.  The bill may also be a vehicle to extend insurance coverage of audio-only telehealth servicesPlease read below on how we need your help advocating for this extended coverage!
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Debate on Coverage for Audio-Only Health Services Moves to Senate – Your Help Needed

Last week, the House Health Care Committee finished recommendations on continuing insurance coverage for audio-only telehealth services. Thanks to advocacy from many VMS members, the House Health Care Committee is recommending covering all medically necessary, clinically appropriate health care services through audio-only telehealth at the same reimbursement rate as in-person services.  While not formally voted on by the House, the recommendations are now being considered in the Senate Health & Welfare Committee for possible addition to a bill on COVID-19 regulatory flexibilities. If you did not yet reach out to the House Health Care Committee, please reach out to members of the Senate Health & Welfare Committee this week!   Your advocacy is making a difference and legislators need to continue to hear how coverage of audio-only services helps provide access to care for your patients. 

Members of the Committee can be reached at: VLyons@leg.state.vt.us; rhardy@leg.state.vt.us; acummings@leg.state.vt.us; chooker@leg.state.vt.us; JTerenzini@leg.state.vt.us

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Legislature Proposes Changes to Act 39: Seeking Feedback

S.74, a bill that would make changes to Act 39, Vermont's Medical Aid in Dying legislation, was introduced in the Senate Health and Welfare Committee this morning. Advocates argue that COVID-19 has made the Act 39 in-person requirements for seeking aid-in-dying medication onerous, particularly for those who are in pain or have difficulty with mobility and/or transport. Vermont is the only state that has in-person requirements for aid in dying and advocates argue that the required provider-patient consultations could be done through telemedicine. The bill would eliminate these current requirements: 

  • that both of the patient’s two oral requests to receive aid in dying needs to be in the physical presence of their doctor;
  • that a physical examination needs to be done to determine if the patient is suffering from a terminal condition; 
  • that the prescribing physician must wait 48 hrs before prescribing the aid-in-dying medication.

The bill would also provide immunity for all parties who are acting in good faith in accordance with the law. Currently, only physicians are explicitly provided protection from criminal liability or professional disciplinary action.  Please provide any feedback on these suggested changes to Act 39 to Jill at jsudhoffguerin@vtmd.org

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Recent COVID-19 Guidance and Resources:

VMS Weekly Zoom with Commissioner of Health, Thursdays at 12:30 pm

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Please Ask Congress to support the “Medicare Sequester COVID Moratorium Act”

H.R. 315, the “Medicare Sequester COVID Moratorium Act” would continue the current Medicare sequester moratorium for the duration of this public health emergency. This congressional fix is necessary to avoid the Medicare payment sequester from taking effect March 31, 2021 and from triggering a devastating financial impact on physician practices across the country. Contact your congressional leaders today to ask them to support this bill. 

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.

DVHA Creates Primary Care Module for PT, OT and Speech Therapy

The Department of Vermont Health Access (DVHA) has created a presentation entitled “Medicaid Authorization for Pediatric Physical Therapy, Occupational Therapy, and Speech Language Pathology Therapy Services.” This presentation is available on the Vermont Health Learn Platform at: https://onecarevt.staging.cm-hosting.com/. The presentation includes two modules. The first module is specifically for primary care providers. The second module is specifically for pediatric re/habilitation therapists. Please complete the brief survey at the end of the presentation. This presentation is the second of many that DVHA will be posting. The goal is to assist providers in understanding Vermont Medicaid’s coverage, to better serve Medicaid members. Future presentations will include information on medical equipment, procedures, and services. Providers who have ideas for helpful presentations are invited to contact AHS.DVHAClinicalServicesTeam@vermont.gov

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Plain Language Sample Telehealth Consent Available for Practices

VMS other health care associations have drafted a sample telehealth informed consent document designed to meet Vermont state law and regulatory requirements for telehealth consent. It is intended to be in plain language so patients understand the form and is based on the Agency for Healthcare Research and Quality template. While consent is not required by Vermont law during the COVID-19 Public Health Emergency, if not practicable, it is best practice to start incorporating this into your workflow. With questions or comments contact Jessa Barnard at jbarnard@vtmd.org.

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Changes to ACO Prior Authorization Waiver


For dates of service March 1, 2021 onward, physician-administered drugs (PADs) for Medicaid members will no longer qualify for a waiver of prior authorization for ACO-attributed members. Any claims submitted for PADs that require a PA on or after March 1, 2021 must have an associated prior authorization from DVHA. Prior to this, members attributed to the Vermont Medicaid Next Generation ACO program qualified for a prior authorization waiver for these services. These services no longer qualify for the PA waiver, and providers must now receive prior authorization for PADs that require a PA for all Medicaid members. The list of PADs that require a PA can be found here: https://dvha.vermont.gov/forms-manuals/forms/prior-authorizations-tools-and-criteria/aco-prior-authorizations.

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New Information Blocking Rules Take Effect April 5 – Resources Available

New federal “information blocking” rules go into effect on April 5. To help organizations prepare, eight prominent industry groups have pooled their efforts to launch the Information Blocking Resource Center, a free online resource packed with helpful guidelines and documents.  Physician practices might want to start by reviewing American Medical Association resources such as What Is Information Blocking? and How Do I Comply with Info Blocking and Where do I Start? Physicians can experience info blocking when trying to access patient records from other providers, connecting their electronic health record (EHR) systems to local health information exchanges (HIEs), migrating from one EHR to another, and linking their EHRs with a clinical data registry. Patients can also experience info blocking when trying to access their medical records or when sending their records to another provider. Under the new rule, for nearly all electronic health information requests, physicians must respond and release patients’ medical records unless an appropriate exception can be identified and used.  For example, the rule requires all physicians to make their office notes, lab results, and other diagnostic reports available to patients as soon as the physician’s office receives an electronic copy. Medical practices are urged to review all policies related to their responses to information requests and update their policies and procedures as needed. Practices should also ask for information from their EHR vendor on their preparations for complying with the info blocking rules. Vermont Information Technology Leaders (VITL) staff are available to talk with providers and health care organizations about both the ONC and CMS rule requirements that take effect this spring. Reach out to Maurine Gilbert at mgilbert@vitl.net

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Vermont Medicaid Seeking Input on How to Improve Medicaid Program

Vermont’s Global Commitment to Health 1115 Demonstration waiver expires at the end of 2021. This is an agreement between the Centers for Medicare and Medicaid Services (CMS) and the Vermont Medicaid program giving Medicaid flexibility in how it uses federal funds. A new application must be submitted to CMS the by June 30th, 2021. In advance of drafting the renewal request, the Vermont Agency of Human Service (AHS) is holding an open meeting on February 25, 2021 from 2:00 to 3:30pm to hear from stakeholders. The meeting will focus on answering “what would improve Vermont’s Medicaid program related to your/your constituency’s goals?” Proposals should include:

  1. What is the problem you are trying to address?
  2. What is your proposed solution to the problem?
  3. How does this promote: transformation to value-based payment, improved care coordination, promoting public health/prevention or increasing access to care?

More information can be found here and comments can also be submitted in writing to Jill at jsudhoffguerin@vtmd.org by February 23, 2021.

        EVENTS

        VMS Advocacy Month: Congressional COVID-19 Town Hall

        Please join us on Thursday, February 25, 2020 from 12:30 pm to 1:30 pm for our VMS Town Hall discussion with invited Congressional delegates to discuss COVID-19 relief, the Biden Administration's COVID vaccine plan and other federal health care policy initiatives. The VMS has invited Rep. Peter Welch, Senator Leahy and Senator Sanders to this virtual Town Hall discussion on Thursday February 25th during our regularly scheduled Commissioner Call, as Commissioner Levine is teaching that afternoon. No registration required. 

        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

        UVMMC: COVID-19 in Rural America – Challenges, Solutions, and Tele-ICU

        Feb. 17th 7-8PM

        The University of Vermont is offering this FREE Anesthesia webinar as a pre-conference for medical professionals planning on attending the virtual Anesthesia Conference March 1-4, 2021. Register here for the webinar. 


        Special Enrollment Period from Feb. 16-May 14th, 2021


        Due to the COVID-19 emergency, Vermont Health Connect has opened a Special Enrollment Period from February 16 through May 14 2021. During this time, any uninsured Vermonter can sign up for a qualified health plan through Vermont Health Connect. Qualified families can also get financial help paying for coverage. Please call us 1-855-899-9600 to learn more.


        VTMD.ORG

        Vermont Medical Society

        134 Main Street

        Montpelier, VT 05602

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