May 4, 2021


VPHP Medical Director Joe Lasek, M.D.: VPHP is Here to Assist You

I’m reaching out today to express gratitude for the lifesaving and often thankless work you all do a daily basis to support the health and well-being of Vermonters and doing so during a year that has been among most difficult most of us can remember.  Through it all, you and so many of our fellow citizens have persisted in helping us get through this extraordinary time.  But the stressful effects of the past year have taken a serious toll on many helpers and first responders.  

While we have shown up to be there for others, many of us are struggling with a number of issues including anxiety, insomnia, post-traumatic symptoms and substance use.  A recent study has showed that these difficulties are startlingly prevalent among health care providers (Source: here ).  Though we would all tell our patients that getting appropriate support is both effective and necessary, health care professionals often shoulder their burdens on their own.

Vermont Practitioner Health Program is available as a confidential resource for referral recommendations or for more structured support if needed. Please contact us with any concerns you might have or if you have a concern about a colleague. We’re here to assist you. Here is the Confidential Phone Number: 802-223-0400. For more information click here or email Colleen Magne at


VMS Member Survey Launching May 6th - What are your priorities? How is VMS Doing?

After taking last year off due to the pandemic, VMS is back with our annual member survey.  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? Our advocacy is only as strong as the information we get from our members. Please take 5 minutes to fill out a new streamlined survey that will help shape our 2021-2022 priorities. A survey link will be emailed to you individually from SurveyMonkey beginning this Thursday, May 6th. You will have until May 27th to complete the anonymous survey and will receive two reminders.  If you do not receive a link to the survey by the end of the day on May 6th please email Elizabeth Alessi at for assistance.  Thank you for helping VMS serve you!


Vermont Legislature Advances Towards Adjournment

The Vermont legislature continues to work diligently to complete their work on all remaining bills eligible to pass during the 2021 session. The Senate passed their version of the FY22 Budget, which is the only bill that actually has to pass this session, by a vote of 30-0 last week. This week, the FY22 Budget advances to the House floor, where they are likely to request a Conference Committee made up of three House members and three Senate members to hash out a compromise on areas where the chambers disagree. The VMS will work to ensure the primary care physician scholarships remain funded in the budget and will continue to advocate to add an increase in Medicaid payments to 105% of Medicare for primary care. The Senate also advanced several VMS priority bills last week: H.104a study of telehealth licensure, H.171a childcare financing bill, H.210a bill to create an office of health equity and H.430a bill to expand Medicaid coverage for migrant families. The House Health Care Committee has scheduled to review Senate changes on these bills before they go to the full House floor for final approval. S.3,the forensic mental health system bill, passed the House Judiciary Committee by a vote of 11-0 and now advances to the House Appropriations Committee. Last week, the House Health Care Committee also voted to support S.22, a bill aimed at ensuring patients have accurate information regarding risks and FDA-approval status of stem cells administered outside of clinical trials, and it will move to the House Floor. This week, the House Government Operations Committee will focus on  S.25, a bill making modifications to Vermont’s tax and regulate commercial sales of recreational marijuana, including additional advertising restrictions.


Biden Administration Loosens Federal X Waiver Requirement to Administer MOUD

Last week, the Department of Health and Human Services (HHS) released federal guidelines changing a longstanding requirement that in order for clinicians to prescribe buprenorphine they need to get an "X-waiver." The X-waiver includes an eight-hour training  to prescribe the drug and many substance use disorder experts have argued it creates an unnecessary hurdle to treating opioid addiction. Under the new guidelines, qualified physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists and certified nurse midwives are exempt from undergoing training to treat up to 30 patients with buprenorphine. Although health care clinicians won't need to get the waiver, they are still required to send a notice of intent to prescribe buprenorphine from HHS’s Substance Abuse and Mental Health Services Administration (SAMHSA). Health care clinicians who intend to treat more than 30 patients will need additional training and federal waivers. Currently, the Vermont Department of Health is proposing changes to Vermont's MAT rule. It is unclear how these federal changes will impact the State's proposed changes.  


Gov. Scott Says Your Mom Wants You to Get Vaccinated for Mother's Day

The Scott Administration reported that Vermont is now ranked number 1 in the nation in terms of residents who have started their COVID-19 vaccination schedule. Currently, 57.4% of Vermonters have received at least their first dose of the vaccine, but there is a sharp disparity in the number of those over 40 who have received their vaccine, 70 percent, vs. those under 40, which is 41 percent. In an attempt to attract younger Vermonters, between the ages of 18-29, who still have not scheduled their vaccine appointment, the State is going to provide clinics across the states with walk-in and drive-in opportunities. With ample supply anticipated, the State reportedly wants to make getting a COVID-19 vaccine as easy as possible for every Vermonter, in order for us to meet the benchmarks that will allow Vermont to fully reopen by July 4th. Here are the comprehensive VMS Governor's Press Conference Notes - 5.4.21


Recent COVID-19 Guidance and Resources:

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


House Health Care Committee Seeks Action on the Youth Waiting in Emergency Rooms

This morning, the Commissioners of the Department of Mental Health, Department of Vermont Health Access and Department of Children and Families presented to the House Health Care Committee immediate, mid-term and long-term solutions to the crisis of children waiting in emergency departments for mental health care. They noted that this systemic issue is symptomatic of inadequate “flow” in the system due to many contributing factors, including increased mental health needs due to COVID 19 and the reduced capacity of school and support services. This includes severely limited in-patient beds due to COVID 19 restrictions  - currently 13 beds out of a total of 48 in the State are closed due to restrictions. 

Some of the solutions presented included:

  • Reducing COVID-19 restrictions on in-person services allowed by hospital, residential and crisis facilities, which would allow for more capacity
  • Improving access to CVPH for Vermont children and youth
  • Improve emergency department triage with ED Directors and Care Managers
  • Distribute federal funding to support additional community mental health services and workforce needs
  • Implement mobile response and emergency department diversion options
  • Work with VAHHS to support EDs
  • Support the Agency of Education on recovery planning to address social, emotional, mental health needs of students and educators
  • Addressing workforce issues
  • Look at possible changes in payment options and structures
  • Enforce mental health parity with private insurers

The Committee will continue to hear from witnesses and VMS will keep you informed with any updates and/or outcomes. The full presentation can be viewed here.

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.

This week, Thursday May 6th, 2021: Marjorie Myers, M.D., will present on Women's Health Issues and the COVID-19 Vaccines, along with Commissioner Levine. 

Join Zoom Meeting:

Meeting ID: 867 2625 3105 / Password: 540684

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


AMA Wants to Hear From You as Medicare Begins Advance Payment Recoupment

The Centers for Medicare and Medicaid Services (CMS) recently began automatic recoupment of COVID-19 Accelerated and Advance Payments, which were an advance of up to three months of Medicare payments to help physician practices keep the lights on early in the COVID-19 pandemic. The American Medical Association (AMA) and the Federation of State Medical Societies strongly advocated for improved repayment terms, which Congress and CMS adopted in 2020. Under the revised repayment terms, physicians should be aware that:

  • These funds are loans that are required to be repaid.
  • Repayment begins one year from when the Medicare advance payment is received, rather than 120 days under the original terms.
  • The per claim recoupment amount was reduced from 100% to 25% for the first 11 months, and then 50% for an additional six months.
  • If there is an outstanding balance after the 17-month recoupment time frame, the Medicare Administrative Contractor (MAC) will issue a demand letter requiring repayment subject to an interest rate of 4%, a decrease from the original interest rate of 10.25%.
  • Physicians may repay the Medicare advance payment in full at any time by contacting their MAC.

The AMA is very interested in feedback about recoupment of the Medicare advance payments. Please share your feedback with Jessa Barnard at and we will forward to the AMA. 

For more information about the programs established by the federal government to help physician practices offset the financial impact of COVID-19, access these AMA resources

National Government Services has also developed a Part B COVID-19 Accelerated and Advanced Payment, Repayment and Recoupment Process YouTube Video to address common questions. 


UVMMC Seeks Primary Care Practice for Opioid Prescribing Study

The Office of Primary Care at the Larner College of Medicine at the University of Vermont is inviting Northern New England Primary Care practices to participate in a research study that supports their quality improvement projects on better opioid prescribing and chronic pain management. Stipend of $10,000 for each practice. Starts April 2022 if approved. Contact: Principal Investigator Connie van Eeghen Dr.P.H. MHSA at


          Please Join us for the VMS May 2021 Webinar: What You Have Missed in Compliance!

          Please join us on Thursday, May 20, 2021 from 12:00 pm to 1:00 pm for our VMS May webinar "What You Have Missed in Compliance!" with presenters Anne Cramer and Shireen Hart. After a year of enormous disruption and change, this program will educate you on areas of critical federal and state regulatory changes for physician practices in 2021, including:

          • New informed consent requirements for audio-only telehealth
          • New information blocking rules
          • Vaccine mandates
          • Employment law changes

          Bring your questions for top health care law experts! Click here to register. 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.

          VMS Offers Facilitated Well-Being Gatherings to Vermont Practices

          Supported by grant funding from the Physician Foundation, VMS is able to offer clinician well-being gatherings at Vermont practices this Spring. Gatherings can be hosted by individual practices or groups of practices that want to offer their clinical staff peer support during this stressful time. At the session, Lumunoswellbeing facilitators will provide an interactive experience of peer support; share ideas and resources for how groups of clinicians, practices, health systems or individuals can create a peer support structure moving forward. Program content and length can be tailored to your practice’s needs. For more information, see program flyer or contact  

          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.

          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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