March 16, 2021


A Year of COVID: VMS Honors Our Members Who Moved Mountains 

Last March, no one could have anticipated the impact the COVID-19 virus was about to have on all of our lives, or that one year later the urgency for information and understanding would not have waned. We also could not have foreseen the herculean response our VMS members, and other healthcare professionals, would need to consistently provide day-in and day-out across the entire State of Vermont. THANK YOU! We at VMS draw our inspiration and dedication from you and will continue to do everything we can to support your efforts to provide the very best care to your patients. For many of us this year has brought loss and difficult changes, but it has also brought increased collaboration and information sharing; creative solutions to long and short-term problems and possibly improved ways to better meet the health care needs of all Vermonters. Please join us this Thursday, March 18th from 12pm-1pm for the VMS Thursday Webinar for March: "Practicing in a Pandemic: A Panel Discussion to hear from four VMS member clinicians, on how they've adapted their practice during the COVID-19 pandemic. To register click here. This panel will allow for in-depth discussion and cover these topics:

  • Lessons in Leadership & Communication Garnered During the Pandemic, with Trey Dobson, M.D., 
  • Adapting Orthopaedic Care to The COVID World with Matthew Prohaska, M.D., 
  • VCHIP & Pediatric Community Perspective, with Wendy Davis, M.D., 
  • Primary Care & Telehealth, with Katie Marvin, M.D., 

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. 


American Rescue Plan of 2021 Brings Dollars to Vermont, Health Care

On March 11, President Biden signed into law the American Rescue Plan Act of 2021, which includes a number of provisions that affect physicians and other health care providers. It will also bring over $2 billion dollars into Vermont to support municipalities, infrastructure, individuals, the education system, childcare, public transit and more. Some of the major sections that impact health care are summarized below. VMS will be monitoring the work by the legislature and Scott Administration to allocate this funding and ensure physicians receive the financial support needed to weather the pandemic.


  • $7.5 billion directed to the Centers for Disease Control and Prevention to plan, prepare for, promote, distribute, administer, monitor and track COVID-19 vaccines
  • $47.8 billion to continue implementation of an evidence-based national COVID-19 testing strategy
  • $7.66 billion to state, local and territorial public health departments to hire staff and procure equipment, technology and other supplies to support public health efforts
  • $100 million for the Medical Reserve Corps
  • $800 million for the National Health Service Corps
  • $200 million for the Nurse Corps
  • $330 million for teaching health centers that operate graduate medical education.
              • $8.5 billion to established Provider Relief Fund for eligible rural providers for healthcare-related expenses and lost revenues attributable to COVID-19 not reimbursed (or obligated to be reimbursed) by other sources
              • Rural providers and suppliers seeking the ARP funds must submit an application to HHS
              • (This is in addition to about $25 billion that remains to be allocated out of the Provider Relief Fund (PRF) established by the Coronavirus Aid, Relief, and Economic Security (CARES) Act, passed in March 2020)
              • $500 million to the Department of Agriculture to award grants to eligible entities, including certain rural providers, based on needs related to the COVID-19 pandemic
              • An additional $7.25 billion allocated to the Paycheck Protection Program
                        • $3 billion for block grants to state and local government entities to address mental health and substance use disorders


                          • $350 billion to states, localities and tribes ($220 billion to states, $130 billion to local governments) to be used until December 31, 2024. Can be used for public health efforts responding to the COVID-19 pandemic, and for efforts to address the pandemic’s economic impact, including assistance to households, small businesses and nonprofits. It can also be used to make investments in public health infrastructure and to respond to decreases in revenue due to the COVID-19 pandemic. Click here to read more.

                          VMS Advocacy Moves Several Priority Bills Towards Passage After Clearing Crossover

                          Last Friday, March 12th was a frenzied day of action for the Vermont legislature and for the VMS policy team. Many of our priority bills were voted out on Friday, which was the final day of the crossover deadline for legislation to have passed out of the first chamber's policy committees in order to continue to advance during the 2021 legislative session. Several bills now move to appropriations and tax committees, which have until March 19th to pass legislation. Other bills will go directly to their respective chamber floors for full debate by either the House or Senate before advancing to the next chamber. 

                          Here's a quick summary of the status of VMS priority bills:

                          • S.3, a bill to create a forensic mental health system, made crossover as it passed the Senate Judiciary Committee by a vote of 4-0-1. This bill is now in the Senate Appropriations Committee.  
                          • S.22, a bill regarding health care practitioners administering stem cell products not approved by the U.S. Food and Drug Administration, passed the Senate and has been referred to the House Health Care Committee. 
                          • S.25, a bill making changes to the cannabis commercialization bill, made crossover and was passed by the Senate Judiciary Committee with strong limitations on advertising and requirements for 30 percent of cannabis sales revenue to go toward prevention programming. This bill has advanced to the Senate Appropriations Committee.
                          • S.24, the bill to prohibit the sales of flavored tobacco, passed the Senate Health and Welfare Committee by a vote of 3-2, but did NOT make crossover, as it has to be heard in the Senate Economic Development, Housing and General Affairs Committee and then the Senate Appropriations Committee. It can still pass during this biennium but not in 2021. 
                          • S.30, a bill to prohibit the possession of firearms in hospitals made crossover as it passed the Senate Judiciary Committee by a vote of 3-1-1. The bill will be heard on the Senate floor Thursday. 
                          • S.53, a bill to provide a tax exemption for feminine hygiene products made crossover and passed the full Senate and is now in the House Ways and Means Committee.
                          • S.117, the COVID-19 emergency flexibilities bill made crossover, was passed by the Senate and had its first hearing in the House Health Care Committee today. This bill includes a compromise on extending insurance coverage for audio-only telehealth services, which will allow the Department of Financial Regulation (DFR) to adopt rules regarding the reimbursement rate for audio-only services for insurance plan years 2022, 2023 and 2024. 
                          • H.104, a bill to study permanent interstate telehealth licensing flexibilities, made crossover and passed the House Health Care Committee by a vote of 10-0-1 and moves to the full House for a vote. 
                          • H.210, a bill to create a Vermont State Office of Health Equity and to develop Continuing Medical Education to address cultural competency, made crossover as it passed the House Health Care Committee by a vote of 9-1-1and will advance to the House Appropriations Committee this week. 

                          Governor Eyes Fourth of July as Target to Lift State of Emergency

                          During today's press conference, the Governor announced that the federal government has provided the State confirmation that Vermont will begin to receive a consistent, reliable supply of all three COVID-19 vaccines -  Pfizer, Moderna and Johnson & Johnson - beginning at the end of March 2021. With an accurate estimate of Vermont's vaccine supply the Scott Administration can now finalize the State's COVID vaccination plan for all phases and all demographic populations, which they plan to provide this upcoming Friday. The Governor was hopeful that by the Fourth of July, he would be able to lift the State of Emergency Executive Order and Vermont would return to some sort of normalcy. Although the State continues to make progress in prioritizing Vermont's Black, Indigenous and People of Color (BIPOC), with Dr. Levine announcing specific clinics being held this week for BIPOC communities, the State has not prioritized distribution of the COVID-19 vaccination to Vermont's incarcerated population, which is disproportionately made up of people of color. Both the Vermont Medical Society, along with eight other Vermont health care organizations, and the COVID-19 Vaccine Implementation Advisory Committee have sent letters urging the Scott Administration to immediately amend its vaccination policies to provide access to Covid-19 vaccines to all incarcerated individuals in its care. 

                          The State continues to expand access to COVID vaccination services to 16-64 yr old Vermonters with specific high risk health conditions (HRHC). Last week, the Vermont Department of Health released a memo for practitioners outlining the registration process for patients with indicated HRHC (listed on page three of the document). They also included a list of ICD-10 codes that may be helpful in identifying and verifying those eligible for COVID-19 vaccination. Practices may be contacted to verify a sample of patients as having HRHC. Teachers, school staff and childcare staff are also eligible to receive their COVID-19 vaccine at on-site school vaccine clinics or through the Walgreens, Kinney Drugs or CVS pharmacy programs. They can make an appointment only AFTER being contacted by school leadership or by the Department for Children and Families, which will provide a code. Appointments are required and the clinics cannot accept walk-ins. 


                          Recent COVID-19 Guidance and Resources:

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


                          AMA Advocacy on Medicare Payment for COVID-19 Vaccine Administration

                          Today, the Biden-Harris Administration nearly doubled Medicare payment for administration of the COVID-19 vaccine, including administration of vaccines requiring two doses, to $40 per administration. This follows significant advocacy by the American Medical Association (AMA) and the AMA/Specialty Society RVS Update Committee (RUC) with the Biden transition team, Congress and the Centers for Medicare & Medicaid Services (CMS) to increase payment to ensure adequate reimbursement for the administration of these life-saving vaccines for Medicare patients, while ensuring there are no out-of-pocket costs for patients. On the second day of the Administration, the White House called on CMS to review the cost of administering vaccines to evaluate whether a higher rate would more accurately compensate physicians. The updated Medicare payment rate reflects the additional resources necessary to ensure the vaccine is administered safely and appropriately. The AMA and RUC brought to the Administration’s attention the increased expenses to safely administer the vaccines and provide in-person care during the public health emergency. These costs are described by the CPT Editorial Panel with the new CPT code 99072 and are now bundled into the new COVID immunization administration payments. 

                          AMA Action: Please Tell Congress to Stop Medicare Cuts!

                          Stop physician Medicare payment cuts NOW!

                          Congress took action in December, 2020 that postponed the Medicare sequester until March 31, 2021. Yet, absent additional Congressional intervention, these harmful payment cuts could be re-imposed on April 1, 2021. If Congress doesn't act by March 31, the Medicare payment sequester will take effect, triggering a devastating financial impact on physician practices across the country, many of which are already strained to the breaking point.

                          Now to make matters worse, physician practices confront an even greater threat of Medicare cuts in 2022. According to the Congressional Budget Office, the passage of the American Rescue Plan Act has set in motion PAYGO statute reductions in Medicare spending of 4% next year, totaling $36 billion.

                          Thankfully, H.R. 315 the “Medicare Sequester COVID Moratorium Act” has been recently introduced in Congress. This bipartisan legislation would continue the current Medicare sequester moratorium for the duration of this public health emergency.

                          Please contact your member of Congress and Senators today and urge them to support the “Medicare Sequester COVID Moratorium Act” today!!

                          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


                          VDH Proposes Changes to MAT Rule: Hearing on April 2nd

                          The Vermont Department of Health proposed Rule 21P004 on March 3, 2021, which would amend the Medication-Assisted-Treatment (MAT) Rule to:

                          1. Remove all patient load limits that are determined at the federal level and change periodically;
                          2. Require providers with 100 clients to submit to the Department for review a continuity of care checklist to ensure they have an adequate plan for the continued care of their patients should there be an issue with a practitioner's ability to provide services; and
                          3. Update terms, references, and formatting. 

                          For the proposed rule amendments click here. There will be a virtual hearing at 10:00 am on Friday, April 2nd. Please send any questions or suggestions on this rule change to Jill at


                          DVHA Proposes Changes to Rules Regarding Non-Physicians Ordering Home Health, Etc.

                          The Department of Vermont Health Access (DVHA) has proposed changes to update Medicaid coverage requirements for home health services, durable medical equipment and medical supplies. These rules are being amended to allow non-physician providers working within their scope of practice to order and conduct the face-to-face visit as required by Medicare. There will be a virtual hearing on the rules listed below on April 7th at 12:00 pm. Please send any questions or suggestions on this rule change to Jill at


                          VPQHC Launches Health Equity Training Starting in March

                          The Vermont Program for Quality Health Care (VPQHC) is offering free health equity training for health care clinicians that will qualify for 3 CME credits, entitled, "Structural Competence and Cultural Humility to Address Disparities and Inequities." This training is being provided by Dr. Maria Mercedes Avila, PhD, MSW, MED and will focus on increased awareness of biases, increased knowledge of cultural and linguistic competencies and increased knowledge of the link between racial inequities and health outcomes. This training is being offered on three different dates throughout Spring 2021. Click here to learn more. 


                          Applications Open for Medical Justice in Advocacy Fellowship

                          The AMA and the Satcher Health Leadership Institute at Morehouse School of Medicine announced the inaugural Medical Justice in Advocacy fellowship aiming to advance equity and remove barriers to optimal health for marginalized people and communities. This collaborative educational initiative is open to eligible physicians and residents with a demonstrated interest in health equity and advocacy. Selected participants will receive a stipend of $15,000 and will be eligible for up to 28 CME credit hours. The deadline to submit applications is March 31, 2021. Learn 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. 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


                                Bi-State Offers Virtual Diabetes Care Trainings on Thursdays from 2-3pm. Please contact Kaylana Blindow

                                March 25, 2021

                                "How to Maximize Diet Interventions for your Patients with Diabetes and Hypertension," Kate Bean, RD, CHWC, CDCES and Morgan Gosselin, MS dietetic intern

                                April 8, 2021

                                "Making Sense out of Sensors: A Review of Considerations for Use of Continuous Glucose Sensors," Donna Hunt, RRMC Diabetes Program

                                "Perspectives on Connection, Compassion and Belonging"

                                Howard Center 4th Annual Conference

                                March 30, 2021


                                Howard Center’s annual conference is designed for a broad audience, including mental health and healthcare providers, educators, clients and families, representatives of state and local government, law enforcement, the judiciary, and the general public. Click here for more information and to register. 

                                Maladies & Medicines: Opioids in the Queen City

                                April 7, 2021, 7:00-8:30 p.m.

                                Champlain College (virtual)

                                What lessons can we learn about the opioid epidemic by looking at it through a historical lens? Champlain College's eighth annual Local History Event will feature two historians' research on opium, morphine, and opioid addiction in nineteenth-century Burlington. I Visit for more information and to register for this free community event. 

                                Reducing Implicit Bias in Health Care: Moving Toward Equal Treatment

                                April 8th, 1:00 - 3:00 PM

                                Join Northern Vermont AHEC for the third session of a 5-part virtual series, Quality Care is Equitable Care: The Case for Culturally and Linguistically Responsive Health Caretargeting Vermont health care practitioners and partners. To register for Session 3 and/or learn more about each monthly activity click here. 

                                2021 Rx Drug Abuse and Heroin Summit Goes Virtual

                                April 5th-8th 2021

                                The Rx Drug Abuse and Heroin Summit, the largest and most influential annual conference addressing the opioid and addiction crisis, is taking place online April 5-8. With overdoses increasing at alarming rates, this is a critical year for stakeholders to convene and discuss what is working in prevention and treatment. The virtual conference will feature four days of live education led by multi-disciplinary experts from across the nation. On-Demand access for 60 days will be available for the 75+ Sessions with live Q&A. Register now.

                                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.


                                Vermont Medical Society

                                134 Main Street

                                Montpelier, VT 05602

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