July 27, 2021

NEED TO KNOW

Summer is Legislative Study Season; VMS Active Participant 

Although, the Vermont Legislature typicaly does not officially conduct business from Mid-May to January, summer and fall is still a busy time for policy work and for tackling the broad array of legislative studies passed during the previous legislative session. This year, the VMS is participating or closely following these summer studies focused on health care policy: 

• Interstate Telehealth Licensing: VMS is a stakeholder in the "Interstate Telehealth Working Group," which was created by Act 21 of 2021 and is being led by the Office of Professional Regulation (OPR). The scope of the Working Group's charge is to facilitate the interstate practice of health care professionals using telehealth modalities and the report is due to the General Assembly by December 15, 2021. Click here for the minutes of the June 29th meeting. 
• Forensic Mental Health: The VMS also attended the introductory meeting of the "Forensic Mental Health Working Group," which was created by Act 57 of 2021. This Working Group is directed to deliver several reports to the legislature in 2022 regarding the creation of a forensic mental health system in Vermont. 
• Prior Authorization Alignment: The VMS attended the first prior authorization alignment meeting on July 20th. Pursuant to Act 140, Sec. 10 of 2020, the Green Mountain Care Board (GMCB) has been tasked with drafting a report to “evaluate opportunities for and obstacles to aligning and reducing prior authorization requirements under the All-Payer Model as an incentive to increase scale, as well as potential opportunities to waive additional Medicare administrative requirements in the future.” This report is due on January 15, 2022. The GMCB will be convening a stakeholder group over the summer to inform this report and they are planning three meetings over the summer. 
• Pediatric Mental Health: VMS and the AAPVT Chapter is actively participating in the stakeholder discussions regarding the boarding of pediatric patients seeking mental health services in order to reduce wait times and provide better patient outcomes as required by the legislative letter to stakeholders from Spring 2021.
• Health Care Workforce Strategic Plan: Funding for the work of the Health Care Workforce Advisory group to provide an updated Health Care Workforce Strategic Plan was extended by the FY22 Budget (H.439) and ther final plan is due to the legislature December 1, 2021. 
• Task Force on Affordable, Accessible Health Care: This legislative Task Force was also funded in the FY22 Budget and is required to hold regional listening sessions for Vermonters to provide their perspective on the affordability and accessibility of their health care. 

AMA Warns Congress About Cuts Facing Physician Practices in 2022

The AMA sent a letter to Congress last week expressing objection to a proposed spending offset in the federal infrastructure package that will soon be considered.  The letter states that combined, physician practices face a 9.75 percent cut on January 1. Additionally, potential penalties under the Merit-Based Incentive Payment System (MIPS), which apply to Medicare PFS services, will increase to 9 percent in 2022. All this financial uncertainty comes at a time when physician practices are still recovering from the financial impact of the COVID-19 public health emergency, including continued infection control protocols that, while necessary, have increased the costs of providing care. The AMA strongly urges Congress not to divert increasingly scarce health care dollars for non-health care purposes, and requests Congress to convene hearings on the alarming state of the Medicare physician payment system. 

Patient Notice of Unapproved Stem Cell Products Required as of July 1

As of July 1, Act 61 went into effect in Vermont, requiring that health care practitioners notify patients before administering a stem cell product that has not received approval from the U.S. Food and Drug Administration. The practitioner must provide each patient with the following written notice prior to administering any such product to the patient for the first time:

THIS NOTICE MUST BE PROVIDED TO YOU UNDER VERMONT LAW. This health care practitioner administers one or more stem cell or stem cell-related products that have not been approved by the U.S. Food and Drug Administration. You are encouraged to consult with your primary care provider prior to having an unapproved stem cell or stem cell-related product administered to you.

The same language must also be prominently displayed in the practitioner’s office and in any advertisements. The practitioner must also provide a disclosure form to a patient for the patient’s signature prior to each administration of an unapproved stem cell or stem cell-related product. Violations of the law constitute unprofessional conduct. VMS supported this consumer protection measure to address clinics in Vermont that are marketing unapproved stem cell products with claims of efficacy and safety that are not evidence-based. For more information, see the full law here or contact jbarnard@vtmd.org.

__________________________________________________________________________

Funding Coming this Fall for Practices Caring for Certain Uninsured Children and Pregnant Women

Act 48, passed by the Vermont legislature this session, expands eligibility for Dr. Dynasaur-like Medicaid coverage to all income-eligible children and pregnant women who would otherwise qualify for Medicaid except for their immigration status. In October of 2021 the State will release an opportunity for practices to receive funding (grant or reimbursement) for furnishing health care services to pregnant persons and children who would be eligible for Vermont Medicaid except for their immigration status in accordance with Act 48. This funding will provide a bridge to a state-funded program that will begin summer of 2022 if the Vermont Legislature provides funding for the program during the next legislative session. Vermont Medicaid is currently analyzing what the funding mechanism will be and whether practices, such as free clinics, which do not currently bill Medicaid, will be eligible for the grant funds.  For more information, visit https://dvha.vermont.gov/.

__________________________________________________________________________

Vermont Now Reporting COVID Cases by Vaccination Status

At today’s press conference by the Scott Administration, Commissioner of the Department of Financial Regulation Mike Pieciak shared new slides as a part of his modeling report that track Vermont’s COVID-19 cases by vaccination status (slides 5 & 6). He stated that while the absolute number of cases per 14 days among vaccinated Vermonters looks higher in July compared to April, as a percent of the population, the case rate among vaccinated Vermonters has fallen. Commissioner of Health Mark Levine added that over the course of the pandemic the state is aware of five fully vaccinated Vermonters who have been hospitalized and one who has died and that vaccination is the best protection against hospitalization and death. In response to questions, Governor Scott and Commissioner Levine stated they do not believe the Vermont will need to reinstitute mandatory mitigation measures although Commissioner Levine stated that people who had traveled to high prevalence areas might want to be tested when they return to Vermont, regardless of vaccination status. Levine also stated that more information about requirements for schools for the fall can be expected at next week’s press conference.  Notes from the press conference can be found here. Today, the CDC also announced new mask guidelines recommending indoor masking even for those who are vaccinated in “high” or “substantial” COVID-19 transmission counties – none of which are in Vermont – and for all students and staff in school.  

MISC.

Vermont Primary Care Medical Student Scholarship Launches – Open for Applications until July 30th!!

The Larner College of Medicine has announced the inaugural offering of the VT AHEC Scholars Medical Student Incentive Scholarship for Larner College of Medicine third-year (Class of 2023) and fourth-year (Class of 2022) medical students who are pursuing primary care, including family medicine, internal medicine, pediatrics, obstetrics-gynecology, or psychiatry, and who are committed to future practice in rural Vermont. Up to 10 scholarships worth up to $40,000 towards tuition will be available this year. VMS advocated over the past two years for the legislature to fund this new scholarship program to strengthen the primary care workforce pipeline in rural Vermont and is thrilled to see the program launch. 

Applications must be received by July 30, 2021 and more information can be found here.

______________________________________________________________

Green Mountain Care Board Job Posting Now Available – Clinicians Encouraged to Apply

The job posting for an upcoming vacancy on the Green Mountain Care Board (GMCB) is now live and is available here. Applications are due by August 13, 2021. The vacancy will begin in September as member Maureen Usifer is not seeking reappointment. The GMCB oversees and evaluates the development, implementation, and effectiveness of health care payment and delivery system reforms designed to control the rate of growth in health care costs and maintain health care quality and access in Vermont. The Vermont Medical Society strongly supports a clinician serving on the GMCB and encourages any interested health care professional to apply. The Governor makes appointments to the GMCB from a list of qualified candidates submitted to him by the GMCB Nominating Committee. The Nominating Committee consists of nine members, appointed by the Speaker of the House, Senate President Pro Tempore, Committee on Committees, and Governor. VMS Members can contact Jessa Barnard at jbarnard@vtmd.org to discuss the position.

_________________________________________________________________________

Medicaid Seeking Katie Beckett Medical Expert

Vermont Medicaid is seeking an annual hourly contract with a medical doctor to provide clinical expertise on Katie Beckett appeals and fair hearings on an as needed basis. Specifically, Medicaid requires a medical expert who can provide a clinical opinion on disability determinations and/or level of care assessments in Katie Beckett appeals/fair hearings, and who is available to testify to that opinion in front of the Human Services Board on the State’s behalf.

Qualifications:

• Be currently licensed to practice medicine in Vermont;
• Be free from significant professional licensing decisions;
• Specialize in Pediatrics and/or Disabling Pediatric Disorders;
• Have significant professional experience;

Preferred:

• Be a currently-treating doctor, or have recently been treating; 
• Have experience with testimony;
• Be familiar with Medicaid and the Disabled Children’s Home Care (Katie Beckett) program in particular;
• Be familiar with the Social Security Guidelines and Disability Domains.

The successful candidate will undertake extensive medical record review in Disabled Children’s Home Care (Katie Beckett) program cases. The expert will work as part of a team, including Department staff that gather and make the original determination and Assistant Attorneys General which defend the Department’s decisions at the hearing level. 

If interested, please email Ashley Berliner, Director of Medicaid Policy, at Ashley.berliner@vermont.gov.

It was brought to our attention that Medicaid was rejecting claims for the administration of the Pfizer COVID-19 vaccine in 12-15 year olds. There was a glitch in their system that was preventing payment in this age group and they have corrected the following codes to allow for reimbursement for the vaccination of those 12yrs and up. Practices should resubmit any claims that have been denied.

EVENTS

New Summer Schedule! Commissioner Call Update | VMS calls with Vermont Department of Health Commissioner, Mark Levine, M.D. will be held on specific Thursdays from 12:30-1:00 p.m. throughout the summer. These calls are on ZOOM - click below for the virtual meeting address that will remain constant each week.

The next summer dates are: August 5 & 19th; September 2 & 16^th.  
Click here for an online schedule.

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

This Week! July 30th is the Deadline for VMS Leadership Award Nominations & Resolutions!

Who do you know that should receive an award for their outstanding leadership throughout the pandemic? The Vermont Medical Society will be accepting nominations for its Annual Leadership Awards until July 30, 2021. To view the award categories and criteria click here. VMS is also looking for your input on 2021 Policy Resolutions to be considered by the membership at the VMS Annual Business Meeting on November 6th. Submit your resolution idea here.

The VMS, in collaboration with the American Academy of Pediatrics Vermont Chapter, Vermont Academy of Family Physicians and the Vermont Psychiatric Association will host the 2021 VMS Annual & Collaborative Meeting on November 5 and 6th, 2021 at the Topnotch Resort in Stowe, VT!  This year's event has been streamlined and features both in-person and virtual options to participate. For more details on the meeting click here. Make sure to save the date and book your room today with the VMS room block. Call Topnotch at 1.800.451.8686. Watch for the registration link next week!

Vermont Suicide Prevention Symposium 

Wednesday, August 4, 2021

9:00 AM - 4:00 PM 

This year's Symposium is being offered as a resource and day of networking for all interested individuals and groups across Vermont and beyond. Register and learn more here. 

Sponsored jointly bythe Mayo Clinic,
Stanford University and the American Medical Association

American Conference
on Physician Health
October 7- 9, 2021

“Achieving the quadruple aim: Resilient systems in times of crisis.” Joint scientific conference that promotes scientific research and discourse on health system infrastructure, and the actionable steps organizations like yours can take to improve physician well-being.

• Registration rates: Available through Thursday, Sept. 23.
• To register for conference and view agenda, visit the ACPH 2021 homepage.

AMA Steps Forward Webinar Series

• August 10 (1:00 - 2:00)
  Implementing innovative solutions with an equity lens. Register Here

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

-- Unsubscribe --