May 25, 2021


School’s Out for Summer: Vermont Legislature Adjourns the 2021 Virtual Legislative Session

Last Friday, the Vermont legislature said farewell to their colleagues in their Zoom squares, as they successfully closed out the historic, fully remote, 2021 legislative session. Although the term “unprecedented” has possibly been worn out after 14 months of this pandemic, this session has been like no other for several reasons: most notably the unfathomable amount of federal relief money and unanticipated bump in state revenue that allowed lawmakers to make significant investments in the future of Vermont. This year’s budget spending increased by roughly 20 percent over last year’s budget, with the final FY22 Budget allocating $7.35 billion, that’s with a “b,” and was buoyed by roughly $600 million in American Rescue Plan Act (ARPA) dollars and $200 million in additional state revenue. This year’s budget moved the needle on services that impact social determinants of health with significant investments in health equity advancement, community mental health services, affordable housing, universal broadband, climate change and access to affordable, quality childcare. Workforce was a top priority, as the legislature invested in scholarships for nursing and primary care professions, mental health providers and childcare providers. Health reform was also an ongoing priority with dollars appropriated for delivery system reforms and the creation of a legislative taskforce focused on how Vermont can achieve affordable, accessible health care. Next week, the VMS will publish our 2021 Final Legislative Bulletin that will provide a comprehensive update on the status of all of the health care proposals we have been following this session. Also, our next VMS Webinar on Thursday, June 17th, 2021 will provide you with what you need to know about the 2021 New Health Care Laws and will feature VMS’ Jessa Barnard and Jill Sudhoff-Guerin. Click here to register. This is the last webinar in our 2020/2021 series but for the recordings and presentations of all of our webinars go to: VMS Thursday Webinar series for 2020/2021 . The webinar content will take place from 12-12:30pm and then we will hear from Commissioner Mark Levine as a part of our regular Thursday calls with the Commissioner of Health from 12:30-1pm. 


Resources Highlight New Regulatory Requirements for Practices

Last week, VMS’ monthly webinar highlighted new laws and regulatory requirements that physician practices should be aware of.  Led by attorneys Anne Cramer, Shireen Hart and Mary Elizabeth Platt with Primmer Piper Eggleston Cramer, the presentation highlighted COVID 19 regulatory changes, audio-only telehealth consent requirements, information blocking rules, cybersecurity, employment vaccine requirements and more.  Helpful links to more information were included, and the attorneys have also prepared a fact sheet on how to comply with new information access rules for minors.  They also informed participants that the CMS Interoperability and Patient Access Rule mandated a centralized directory of provider electronic addresses for data exchange be published by the National Plan & Provider Enumeration System (NPPES). The Rule states that all providers must input their digital contact information into NPPES by May 1, 2021, or they will be subject to public reporting for non-compliance.  This is not for your email address but a secure endpoint type such as direct messaging address or FHIR URL provided by your EHR vendor. The contact information in NPPES will be used by hospitals and other providers to send event notifications, PHI, and referrals if they are using NPPES as a resource to obtain your digital contact information. To register for or update an NPPES account, go to


CMS Announcement on MIPS Cost Category

Last Thursday, the Centers for Medicare & Medicaid Services (CMS) announced that the 2020 MIPS Cost Performance Category will be reweighted to 0% of the final score even if eligible physicians or groups submitted 2020 data in other MIPS categories in light of the impact of the COVID-19 pandemic. For over a year, the AMA has been recommending that CMS zero out this category during the pandemic for several reasons, including concerns that decreases in patient visits and increases in the costs of caring for patients with COVID-19 could unfairly penalize physicians. The AMA applauds CMS for holding physicians harmless from unfair evaluations in the MIPS Cost Performance Category as a result of the COVID-19 pandemic. The AMA also strongly supports CMS’ decision to release the 2018 and 2019 cost measure benchmark files, which the AMA will review closely to identify the target spending for those years, how the benchmarks capture any variations in spending, and whether the benchmarks are leading to fair and valid comparisons among physicians.


    AMA issues Joint statement on Supreme Court’s dismissal of Title X cases

    The dismissal of the Supreme Court Title X cases marks another important step forward for patients across the country who have been denied access to essential care during a pandemic. The VMS joins the AMA in expressing relief that all parties, including the federal government, agreed that the litigation over the Trump administration’s “gag rule” is no longer necessary. The VMS and the AMA both submitted comments on the Biden Administration’s proposed rule revoking the Trump Administration’s restrictive rule on Title X and expressed support for the changes made in the rule. For the VMS’ Title X comments click here. For the AMA Title X comments click here.


    AMA Report Shows Private Practice Continues to Decline

    The AMA has released a report analyzing the recent changes in physician employment status and practice size, type, and ownership between 2012 and 2020. The content of the report is based on the AMA’s Physician Practice Benchmark Survey. Although the 2020 data are consistent with earlier trends, the size of the changes since 2018 suggest that the shifts toward larger practices and away from physician-owned (private) practices have accelerated.

    • 2020 was the first year in which less than half (49.1%) of patient care physicians worked in a private practice, a drop of almost 5 percentage points from 2018.
    • 17.2% of physicians were in practices with at least 50 physicians in 2020, up from 14.7 % in 2018.


    Recent COVID-19 Guidance and Resources:

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

    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


    Reminder: Medicare Reimbursement for Cognitive Assessment & Care Plan Services

    The Centers for Medicare & Medicaid Services (CMS) wants to raise clinicians’ awareness about Medicare-covered services to detect and diagnose cognitive impairment. Medicare covers a separate visit for a cognitive assessment so you can more thoroughly evaluate cognitive function and help with care planning for your patients with cognitive impairment

    Below you will find links to resources for additional details about this coverage.

    National Institute on Aging’s Alzheimer’s and Dementia Resources for Professionals webpage


    Please Get Your VMS Member Survey in By Thursday, May 27th!

    We need to hear from you! What policy issues are most impacting you and your patients right now? Surviving COVID downturns in patient volume? Patient mental health needs? After taking last year off due to the pandemic, VMS is back with our annual member survey. Our advocacy is only as strong as the information our members provide us! Please take 5 minutes to fill out a new streamlined survey that will help shape VMS 2021-2022 priorities. This week, every VMS member who did not fill out the survey will be emailed a final survey link from SurveyMonkey. You have until May 27th to complete the anonymous survey.  If you have not received a link to the survey please email Elizabeth Alessi at for assistance.  Thank you for helping VMS serve you!


    NNE-CTR Research Support Survey

    The Northern New England Clinical & Translational Research (NNE-CTR) network is working to enhance the health of northern New Englanders by fostering clinical, translational, and educational research. NNE-CTR has created a survey to connect rural practices with research opportunities to benefit their patients and connect clinicians interested in research with resources. These research supports may include funds for clinical and translational research projects, study design and analysis expertise, mentorship and educational opportunities for career advancement, access to advanced instrumentation, and opportunities for research collaboration between academic centers and community practices. This 5-minute survey is voluntary, and no information will be asked that can identify you. Click here for the survey.


    Green Mountain Care Board Vacancy – Health Professionals Encouraged to Apply

    With a vacancy expected in September 2021 at the expiration of Board member Maureen Usifer’s term, VMS is strongly encouraging health care professionals to apply for an open seat on the Green Mountain Care Board. The opening has not yet been posted, however a job description for prior openings can be found here. The annual salary for a board member is currently $107,000 and Board members can be part-time and have outside work. Board members may practice medicine and be a non-management employee of a hospital or other health care facility, but would be required to recuse themselves from any Board matters which involve their employer. Candidates need not resign these positions prior to accepting a position. Candidates who apply will first be reviewed by a Nominating Committee; qualified candidates are then forwarded to the Governor, who makes Board appointments with the consent of the Senate. More information on the nomination process can be found here. If you have questions or want to suggest candidates, please contact Jill at 


            Building and Cultivating Culturally Effective Organizations

            May 26th, 1:00 - 3:00 PM

            Register today!

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

            2021 Northern New England Society of Addiction Medicine Virtual Spring Scientific Session

            Saturday, June 5th, 2021

            8:00 am-12:15pm 

            Registration now open for NNESAM's 2021 Spring Scientific Session. This virtual event will take place on Saturday, June 5th, 2021 and will be followed by 
            an hour long NNESAM Business Meeting at 12:30 p.m. 
            The American Society of Addiction Medicine has designated this live activity for a maximum of 4 AMA PRA Category 1 Credits. NNESAM is a VMS-managed Specialty Society as of January, 2021. Register here. 

            VCP 2021 Webinar Series: May 27: Collaborative Documentation with Kids and Families Northwestern Counseling and Support Services Children, Youth, and Family Services clinicians share practical advice and lessons learned on using Collaborative Documentation as a clinical intervention to improve engagement with children, youth, and families. Register here.

            June 25: How to Help Your Older Clients Improve their Sleep CSAC Medical Director Dr. Joe Lasek will provide information and strategies for assessing and promoting better sleep for your older clients, including pharmacological and non-pharmacological interventions for insomnia in the elderly. Register here.

            More details on these webinars are available at the VCP Events and Trainings site.

            Child Psychiatry and Family Medicine Conferences 

            14th Annual Child Psychiatry in Primary Care Conference June 4 (virtual) 8:00-4:30pm Dr. David Rettew invites you to attend this year’s virtual conference on: Post-COVID Mental Health for children, School Violence Threat assessments, Integrated Care, The Science of Praising (and Overpraising) and more. Register here.

            Family Medicine Review Course – June 8-11 (virtual) 

            Dr. Anya Koutras invites you to attend this year’s virtual conference. Sessions cover a wide-range of topics including, among many others: anxiety disorders, liver disease, cardiac testing, neuropathy, opiates, hospice care, racism and health inequities, adolescents on the gender spectrum, Type 2 diabetes, and musculoskeletal telemedicine. See the entire program at the event webpage.

            VPQHC Expands Health Equity Training Offerings Due to High Demand!

            The Vermont Program for Quality Health Care (VPQHC) has expanded the free health equity training offerings that qualify health care professionals 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 is currently waitlisted through May. Register here.

            Special Enrollment Period Now Until August 15th, 2021

            Due to the COVID-19 emergency, Vermont Health Connect has opened a Special Enrollment Period through August 15, 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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