Boosters Approved for Immunocompromised and Considered for General Population
On Friday, the FDA authorized and the CDC recommended that certain immunocompromised Americans should receive a third dose of mRNA COVID-19 vaccine at least 28 days after a second dose of Pfizer-BioNTech COVID-19 vaccine or Moderna COVID-19 vaccine. The recommendation directs patients to first consult with their health care clinician regarding whether they are considered moderately to severely immunocompromised and lists these medical conditions as those that would make a patient eligible for a third dose:
- Receiving active cancer treatment for tumors or cancers of the blood
- Received an organ transplant and are taking medicine to suppress the immune system
- Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
- Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
- Advanced or untreated HIV infection
- Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response
The FDA authorization and CDC recommendation only applies to those who have received the mRNA vaccines, as there is not enough evidence to determine whether an additional dose of the Johnson & Johnson COVID-19 vaccine would provide similar protection for immunocompromised people at this time. Vermont Department of Health Commissioner Mark Levine sent a letter to Vermont clinicians on Saturday urging them to do their best to meet the additional vaccine demand from their immunocompromised patients, citing their increased vulnerability to more severe outcomes from the virus and the increased the risk of transmissibility of the delta variant for vaccinated individuals. The letter also said that those who are immunocompromised are the only patients authorized for a third dose at this time. As early as Sunday, it was reported that the Biden Administration has decided that all eligible Americans should receive a booster eight months after they received their second shot, and depending on FDA authorization, they could begin offering the third doses of Pfizer BioNTech and Moderna vaccines by mid-September. Authorization of a second dose of the Johnson & Johnson vaccine is dependent on the results of their current two-dose clinical trial. Distribution will likely start with nursing home residents, health care workers and emergency workers. At Tuesday’s Scott Administration press conference, there were no major changes announced in Vermont policy and officials emphasized that current mitigations measures are sufficient given Vermont’s high vaccination rate and low hospitalization rates. See notes from the press conference here.
On Monday, August 23, 2021 from 12:00 – 1:00 pm the White House COVID-19 Response Team is inviting all health care providers to join a White House Virtual Conversation on "Health Systems, Providers, and the COVID-19 Vaccinations Effort." Click here for more information.
Please click the following link during the event to attend: https://www.youtube.com/watch?v=8Iwkc7ZkK6w
Medicare Codes: Effective August 12, 2021, CMS will pay to administer additional doses of COVID-19 vaccines consistent with the FDA EUAs, using CPT codes: 0003A for the Pfizer vaccine and CPT code 0013A for the Moderna vaccine. The pay for an additional dose will be the same as the other doses of the COVID-19 vaccine.
VDH Adopts Changes to the MAT Rule that Track with VMS/VAFP Advocacy
The Vermont Department of Health (VDH) has adopted final amendments to the Medication-Assisted-Treatment (MAT) for Opioid Use Disorder Rule, which modify the original MAT rule adopted in 2017 and will become effective on October 1, 2021. This past April, the Vermont Medical Society and the Vermont Academy of Family Physicians provided suggestions on both the proposed changes and the existing rule. Thanks to Katie Marvin, M.D., for her successful advocacy to expand the definition of eligible clinicians who can perform a psychosocial assessment required in existing rule under Section 22.214.171.124, to include: primary care doctors (including family physicians, internal medicine physicians, pediatricians, OBGYNs) and primary care advance practice providers (APRN or PAs). The rule previously excluded primary care clinicians and required that a psychosocial assessment only be completed by a clinician in one of the following disciplines: psychiatrist, physician certified by the American Board of Addiction Medicine, psychiatric Nurse Practitioner, psychiatric Physician Assistant, licensed social worker, psychologist, licensed mental health counselor, licensed marriage therapist, licensed alcohol and drug counselor. For the full VMS/VAFP comments click here.
CMS Recalculating MIPS Scores for 2020
According to the AMA, the Centers for Medicare & Medicare Services (CMS) will be updating the Merit-based Incentive Payment System (MIPS) performance feedback and final scores for performance year 2020 and the associated MIPS payment adjustment information for payment year 2022. CMS made the AMA aware that certain MIPS participant scores for 2020 were inadvertently miscalculated and they plan on recalculating all scores to ensure their accuracy. Please look for updated 2020 scores and related 2022 payment adjustment information from the CMS in the next few weeks. CMS reportedly will also extend the deadline to submit an appeal or targeted review request. Please click here for more information.
Mildred Reardon Medical Student Scholarship Application Deadline Extended to August 30th!Do you dream of becoming a Vermont doctor? Apply for a $10,000 scholarship for a rising 3rd year student committed to practicing medicine in Vermont. The Vermont Medical Society’s Education and Research Foundation (VMSERF) is accepting applications for the Mildred Reardon scholarship until August 30th, 2021 from medical students interested in any specialty, with a preference for specialties in high need in Vermont. The scholarship is tuition-linked and paid directly to the College of Medicine towards tuition. The scholarship award is given as part of the VMS Annual Meeting Awards Banquet, which will be held at Topnotch in Stowe on November 5th, 2021. Click here for more information and details on applying for the scholarship.
VDH - HAN - August 9, 2021 - SARS-CoV-2 Monoclonal Antibodies for Post-Exposure Prophylaxis