February 9, 2021


How Will You Lead? Join VMS on February 11th

VMS' 2021 Advocacy Month is well underway and we hope you had a chance to tune into the reading of H.C.R. 9, a resolution recognizing all of Vermont's health care professionals for your sustained dedication during the COVID-19 pandemic. Please register for this week's action: this Thursday, February 11th from 4-6pm for our 2021 Virtual Advocacy Training. Learn how you can use your voice to improve health care policy in Vermont. Get insight on how to get the attention of Vermont legislative leaders: Senate President Pro Tem Becca BalintHouse Speaker Jill KrowinskiSenate Minority Leader Randy Brock and House Minority Leader Patti McCoy . Their valuable experience and insight can help you with your own messaging. We will then take you deeper into the craft of health advocacy messaging, with a peer-led workshop in which we will use real-life 2021 legislative proposals to form your policy "ask."  Click here for the 2021 VMS Advocacy Toolkit for the training curriculum. Choose from one of these breakouts, led by a VMS physician advocate on VMS priorities you are passionate about: 

  1. Access to Reproductive Health: Lauren MacAfee, M.D. will cover Prop 5, the constitutional amendment for reproductive freedom. 
  2. Injury Prevention: Becca Bell, M.D., will cover gun violence prevention bills, STD prevention and the bill to prohibit sales of flavored tobacco. 
  3. Mental Health: Simha Ravven, M.D., will cover the forensic mental health bill and other mental health priorities. 

Click here to learn more about this event where your colleagues will share simple tools to help you craft cogent, effective communication strategies. Register today!


VMS Executive Director Participates in Lt. Gov Broadband Panel

Newly-elected Lt. Governor Molly Gray kicked off her "Seat at the Table" series this week with a discussion on how the COVID-19 pandemic has further exposed Vermont's broadband crisis and the growing digital divide. VMS Executive Director Jessa Barnard participated as a panelist, highlighting the potential of telehealth to bridge longstanding access to care issues. Barnard, along with Betsy Bishop from the Vermont Chamber, Jay Nichols from the Vermont Principal's Association, Philene Taormina from AARP and Zach Tomanelli from VPIRG, discussed how the COVID-19 emergency has shown how "digital equity" must be a critical priority in order for all Vermonters to have access to health care, education, work-from-home and civic engagementClick here to watch the Seat at the Table recording. 


Health Care Committees Move to Address VMS Priorities, COVID-19 Needs

The House Health Care Committee continued work last week to address insurance coverage of audio-only telehealth services after the COVID-19 emergency ends. After completing testimony from witnesses including clinicians, health insurers and patients, the Committee posted a draft bill, which would require insurance companies to provide the same level of coverage and payment for audio-only services as for in-person services through the end of 2024. The proposal would also require that patients agree to receive services over the phone, have the choice to receive in-person services, and are informed if their insurance will be billed. VMS has submitted comments strongly supporting the draft, with a few suggestions for language changes. Thank you to all of the VMS members who submitted statements to the Committee in support of audio-only services – members of the Committee specifically referenced the number of comments received from clinicians. The Senate Health & Welfare Committee is also moving forward with a draft bill to extend certain regulatory flexibilities to respond to the COVID-19 pandemic, such as simplified licensure for retired or out-of-state health care clinicians and renewing buprenorphine prescriptions without an office visit.  VMS testified in favor of the bill last Wednesday and will continue to support the progression of the bill through the legislature. 


COVID-19 Vaccination Continues to Accelerate in Vermont

The Scott Administration announced in today's press conference that Vermont continues to vaccinate more Vermonters in an accelerated, efficient way. Ranking second in New England in vaccination administration, Vermont has provided approximately 65,000 COVID-19 vaccines. Approximately 32% of those in the 75 and older age band have received at least one dose of vaccine, as well as the majority of health care workers in Phase 1A. Homebound Vermonters and members of Vermont's BIPOC population are beginning to be vaccinated. High COVID-19 case counts in Bennington and Rutland counties continue to increase Vermont's case average. Dr. Levine emphasized testing is still first step in containing the virus and announced additional testing locations in those counties. Dr. Levine also announced that approximately 100 people in Vermont's Black, Indigenous, and People of Color (BIPOC) population who require linguistic and culturally appropriate services received the COVID-19 vaccine. Reinforcing that Vermont still has much to do to address systemic disparities and to reach some of the most historically underserved populations in Vermont, Dr. Levine articulated the need to take a different approach in delivering vaccine to Vermont's BIPOC communities because language barriers have led to outbreaks. In identifying 75 and older BIPOC Vermonters living in multigenerational homes, AHS made the decision to allow other household members to receive a vaccination at the same time. Click here for a December 2020 VDH Data Brief on the disproportionate impact of COVID-19 on Vermont's BIPOC communities.


VNA/EMS Begin Vaccination of Homebound Vermonters

Over the weekend, EMS in partnership with the VNAs of Vermont, began vaccinating the 2000 Vermonters who receive home health services and qualify as homebound individuals.  VMS has been collaborating with VDH, VNAVT and EMS to discuss homebound vaccination, including reaching those that do not currently receive home health services, but may be identified by primary care.  VDH is in the process of developing a centralized system to identify any patients who do not receive home health services, but are still considered homebound. Please stay tuned for more information.


COVID-19 Vaccine-Related Axillary Adenopathy Update and Resources

Last Thursday, Dr. Sally Herschorn, M.D., Radiologist and Co-Division Chief and Medical Director Breast Imaging at UVMMC, spoke to VMS members on the linkage between Pfizer and Moderna COVID-19 vaccines and an increase in transient axillary lymphadenopathy in the ipsilateral axilla to the arm where vaccines have been administered. 

In order to reduce unnecessary call-back mammograms, please inform your patients that transient axillary adenopathy is the body’s normal reaction to the vaccine, a sign their body will be making antibodies, and it is not something to be worried about. Resources and guidance:


    VDH Publishes Screening Policy for Health Care Workers in Phase 1A

    Monday, February 1st, 2021 the Vermont Department of Health (VDH) published guidance, providing the latest screening criteria to determine which health care clinicians are eligible to qualify for the Phase 1A COVID-19 vaccination group. If a patient is not eligible based on the screening questions outlined in the guidance, they will need to wait for a new phase of the vaccine rollout in which they meet eligibility criteria. If you are a 1A-qualified individual please contact your hospital to schedule your vaccine now.

    Other hospitals – contact Elizabeth Alessi at the Vermont Medical Society for contact information: ealessi@vtmd.org.


    Recent COVID-19 Guidance and Resources:

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


    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.

    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


    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.


    SVMC Launches Weekly Medical Show

    Get medical updates directly from regional medical experts, including host Trey Dobson, MD, and ask questions during this new online show. Each week, Dr. Dobson will discuss current healthcare topics with a guest or guests as well as answer questions posted by virtual attendees. The show will air at 2 p.m. on Wednesdays starting February 10. Read More.


    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


    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.

          Spotlight on VMS Member Benefits: VMS Membership Renewal Now On VMS Website

          We have now included a link on the VMS website with easy instructions on how to renew your VMS membership. The deadline for renewal was February 1, 2021, but if you missed the renewal date you can still renew before May 1, 2021 without membership suspension. If you have questions on your invoice or need to discuss payment arrangements please reach out to Stephanie Winters at swinters@vtmd.org. 


          VMS February 2021 Webinar: Race and Health Equity

          Please join us on 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 on; guidance and resources for practices working towards creating a culturally safe medical home, for families experiencing racism and screening tools and guidance for pediatricians and families to promote anti-racism. This session will discuss AAP-VT’s process thus far to support pediatricians and other child health providers in addressing this issue. To register click here. To see the entire VMS Thursday Webinar series for 2020/2021 click here. This webinar will take place at the same time VMS is hosting our scheduled Commissioner Call.


          Vermont Medical Society

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          Montpelier, VT 05602

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