September 7, 2021


VMS Council to Weigh Proposed Resolutions, Seeks Nominations for Open Seats

The VMS Council (governing board) will meet next Wednesday, September 15th to consider member feedback on four proposed policy resolutions. The resolutions are:

VMS members wishing to attend the Council meeting, which will be held over Zoom from 6:30-8:30 pm, can contact Birdie Powell at for the log-in information. VMS also has an upcoming at-large Council seat opening and is open for nominations for the Vice President role. All members are encouraged to express interest and the Council seeks to establish inclusive and diverse representation of members in areas such as medical specialty, practice type, geography, group membership and individual demographics. The resolutions and leadership positions will be voted on at the VMS Member Business Meeting, Saturday, November 6th from 9am – 12pm. Contact Jessa Barnard at for more information. 


    CMS Releases Evaluation of Vermont All-Payer Model

    Last week, the federal Centers for Medicare & Medicaid Services (CMS) released an evaluation and summary of findings of the first two performance years (2018 and 2019) of Vermont’s All-Payer Model (APM), finding promising results that indicate the APM and Vermont’s Accountable Care Organization, OneCare Vermont, are on the right track toward transforming the way health care is paid for and delivered. The evaluation of the first two years of the model was conducted by NORC at the University of Chicago, an independent research institution, and assesses the implementation and measures effects of the APM.

    Key findings of the evaluation of the APM include:

    • The APM achieved statistically significant Medicare gross spending reductions at both the ACO and state levels, as well as Medicare net spending reductions at the state level.
    • There were statistically significant declines in acute care stays (at the ACO and state levels) and in 30-day readmissions at the state level.
    • Evaluators found that stakeholders agree that the APM provides an important, unifying forum for providers, payers, and the state to engage in meaningful discussions about healthcare reform and set goals. The APM is also strengthening relationships among hospitals, community organizations, designated mental health agencies, primary care practices, and other providers.


      Texas Law Banning Most Abortions Takes Effect

      By a slim 5-4 vote, the United States Supreme Court did not act this week on a request to stop a Texas law banning abortions after 6 weeks. The law, which has some abortion rights advocates worried that the court might be inclined to revisit Roe v. Wade, a 50-year-old decision protecting a woman’s right to abortion. Here’s more about the law:

      • What the law says: Any pregnancy where a heartbeat is detected cannot be aborted. That effectively means that if you’re six weeks pregnant, you can’t have an abortion in Texas. It’s a threshold that occurs before many even know they're pregnant. The law provides no exceptions for rape and incest but makes an exception for medical emergencies.
      • The law does something else novel: It incentivizes the public to police abortions. It allows a person — anyone living in the state of Texas — to sue an abortion provider they suspect is “aiding and abetting” abortions after that six-week mark. It sets a $10,000 award for any successful lawsuit to stop an abortion.
      • What could happen next: The Supreme Court could still decide to stop the Texas law at least temporarily while lower courts debate its merits. This fall, the justices will hear separate arguments over a Mississippi abortion ban, which could give us a clearer understanding of how this conservative Supreme Court views abortion rights.

      The day after the SCOTUS decisions, United States House of Representatives Speaker Nancy Pelosi said that the House will vote on legislation to guarantee access to abortion upon its return to Washington later this month. In Vermont’s upcoming 2022 legislative session, lawmakers will decide whether to pass Prop 5, a proposed amendment to the Vermont constitution aimed at protecting the right to personal reproductive liberty for all Vermonters. If passed, the question would go on the ballot in November of 2022 and Vermont voters will decide if Vermont becomes the first state in the country to explicitly protect reproductive liberty in its constitution.


      AMA Releases Educational Resources to Advance Equity in Health Care

      In alignment with its commitment to inform and educate physicians on topics important to health equity, the American Medical Association (AMA) last week announcedseries of CME and educational activities aimed at addressing the root causes of inequities, including racism and other structural determinants of health. The new content — featured on the AMA Ed Hub™ Health Equity Education Center and curated by the AMA’s Center for Health Equity— will equip physicians and other learners with core health equity concepts needed to support them as they continue to take action and confront health injustice.

      Prioritizing Equity CME video series

      COVID Black CME module

      Additional new health equity-related modules are scheduled for release throughout the remainder of 2021 and beyond, covering key topic areas such as structural competency, public health, social sciences, critical race theory, and historical basis of disease. An overarching goal of the content is to help learners better understand how systems of power, structures, policies, and practices impact us all.


      AMA, APhA, ASHP Call for Immediate End to Prescribing, Dispensing, and Use of Ivermectin to Prevent or Treat COVID-19 Outside Clinical Trials

      Last Wednesday, the American Medical Association, American Pharmacists Association (APhA), and American Society of Health-System Pharmacists (ASHP) issued a joint statement strongly oppose the ordering, prescribing, or dispensing of ivermectin to prevent or treat COVID-19 outside of a clinical trial. The full statement can be found here.  Ivermectin is approved by the U.S. Food and Drug Administration (FDA) for human use to treat infections caused by internal and external parasites. It is not approved to prevent or treat COVID-19. Ivermectin is also available to treat certain veterinary conditions; medications formulated or intended for use in animals should not be used by humans. The organizations are alarmed by reports that outpatient prescribing for and dispensing of ivermectin have increased 24-fold since before the pandemic and increased exponentially over the past few months. As such, they call for an immediate end to the prescribing, dispensing, and use of ivermectin for the prevention and treatment of COVID-19 outside of a clinical trial. 


      Vermont Medicaid Update on Synagis for Respiratory Syncytial Virus (RSV)

      Vermont Medicaid/the Department of Vermont Health Access (DVHA), in coordination with their Pharmacy Benefits Manager Change Healthcare, review data from the National Respiratory and Enteric Virus Surveillance System (NREVSS) to track the epidemic season for Respiratory Syncytial Virus (RSV). Synagis® is indicated for the prevention of serious lower respiratory tract disease caused by RSV in pediatric patients. While peak RSV activity typically occurs between November and March, RSV activity through the traditional 2020-2021 fall/winter season remained very low and as COVID-19 mitigation measures have been relaxed, RSV activity is on the rise. In response to this atypical inter-seasonal change in RSV activity, the American Academy of Pediatrics (AAP) issued Interim Guidance supporting the use of Synagis® in patients who qualify for coverage per current clinical guidelines during periods when RSV incidence is epidemic in the area. The clinical benefit of Synagis® therapy is best realized by timing the administration to coincide with the peak of RSV activity. DVHA will continue to monitor RSV activity and may end the atypical Synagis® “season” when the percent positives on antigen tests is ≤ 10% for 2 weeks or the percent positives on PCR tests is ≤ 3% for 2 consecutive weeks.  Prior authorization/order forms should be sent directly to Change Healthcare at 844-679-5366.  Additional information and DVHA forms may be found at the following sites:


      State of Vermont Launches Investigation Regarding Long Wait Times for Specialty Care

      Last week, in response to a Seven Days story entitled, “The Doctor Won’t See You Now: Patients Wait Months for Treatment at Vermont’s Biggest Hospital,” Agency of Human Services Secretary Mike Smith announced that the State of Vermont will be launching an investigation into the reported long wait times for specialty care appointments at the University of Vermont Medical Center and other hospitals. Ena Backus, the State’s Director of Health Reform, will lead the investigation and said that she will not focus the exploration on any specific hospital and will not confine it to just specialty care. A few days later, the Green Mountain Care Board and the Department of Financial Regulation announced that they would be joining the effort to better understand long wait times for specialty care across the State. Secretary Smith was quoted as saying, ““We are not trying to punish organizations,” he said. “We really do want to understand the challenges across the system and help identify ways to remove the barriers.” John Brumsted, President and CEO of the UVM Health Network, released a statement after the Seven Days story was published and said that the current situation is unacceptable and that COVID-19 care, along with abnormally high patient volumes and intense patient needs, has resulted in a "perfect storm" that has stressed everyone in the entire health care system. 


      Vermont Vaccine Update Includes 2021/2022 Flu Season Information

      The Vermont Health Department Immunization Program published their "Vermont Vaccine Program Update" for August, 2021. This Update includes important information for health care clinicians on the COVID-19 vaccine, ordering flu vaccine for the 2021/2022 season and setting up flu clinics as well. Click here to read the full Vaccine Update. 


        Medicaid Finalizes Changes to Home Health Ordering Clinicians, PA Authority

        Medicaid has finalized several recent policy changes. Physician assistants, nurse practitioners, and clinical nurse specialists may now order home health services along with physicians. In addition, physician assistants who enroll with Vermont Medicaid may:

        • Act as a treating provider and receive direct reimbursement for services delivered.
        • Choose to be listed as a primary care provider.

        For more information see: GCR 20-063: Home Health Services - Ordering Providers and GCR 20-105: Physician Assistant Licensure Changes—Medicaid Impact

        Vermont Medicaid is also proposing to fully transition continuous glucose monitor coverage to the pharmacy benefit only rather than covering under the durable medical equipment benefit.  For more information or to comment on this proposal see: GCR 21-041: Continuous Glucose Monitors Available Through Pharmacy Benefit.


        Action Required: Feedback on Vermont's Proposed DNR/COLST Order

        A subgroup of the Palliative Care Task Force has been working on revisions to Vermont’s DNR/COLST order over the spring and summer of 2021. The Task Force is seeking final stakeholder input for consideration before the Department of Health moves forward and adopts a new Vermont DNR/COLST form which will be effective January 1, 2022. Please review the current draft Vermont DNR/COLST order form and contact Cindy Bruzzese at with any additional comments or suggestions by NO LATER THAN SEPTEMBER 30, 2021. All comments will be compiled and shared directly with the Department of Health for review and consideration. 


        Relocation Funds Available for Newly Hired Health Care Workers

        The Vermont legislature has funded a New Relocating Worker Grant, with a maximum award of $7,500, to encourage workers to move to Vermont to work for Vermont employers.  Eligible applicants include someone who, on or after July 1, 2021:

        • Relocated to Vermont, became a full-time resident; and
        • Became a full-time employee of a Vermont employer; and
        • Is employed in an occupation identified by the Vermont Department of Labor in its Short Term Occupational Projections with the Most Openings (including many health care positions).

         For more information, visit:


        COMIRNATY Update Calls Through 2021

        Pfizer Vaccines US Medical Affairs team will be hosting “Medical Updates:  Pfizer-BioNTech COVID-19 Vaccine, also known as COMIRNATY® (COVID-19 Vaccine, mRNA),” on Tuesdays, at 5pm ET and Thursday’s at 12pm ET for the remainder of 2021.   

        The topics for the current sessions, subject to change, include:  

        • FDA approval in individuals 16 years of age and older
        • Third dose authorization for immunocompromised persons
        • Packaging update 
        • Shelf-life extension and temperature range  
        • Storage, handling & administration. 

        Please click on the links below to join the sessions at the designated times over the next several weeks:

         Date, time and password

        Attendee link – September 7 – 5 PM ET


        Attendee link – September 9 – 12 PM ET


        Attendee link – September 14 – 5 PM ET


          The 208th Collaborative Meeting: What This Means For You! 

          Have you registered for the 208th Annual and Collaborative Meeting yet? We are going to provide virtual participation options or you can join the VMS, AAPVT, VPA and the VAFP at the Topnotch Resort in Stowe Friday, November 5th and Saturday, November 6th. This year's meeting is brimming full of meaningful opportunities for you to communicate and collaborate with your colleagues and to have some fun as well! Crossing our fingers we can gather in person this fall, Friday evening includes specialty society receptions and our celebratory VMS Awards Dinner. Saturday morning we start the day with our fun run/walk on the beautiful, Stowe bike path and we know we will all unwind at Saturday's networking lunch. There is also plenty of opportunities to take advantage of the relaxing amenities of Topnotch in the gorgeous town of Stowe. Register today

          Today is the last day for you to provide feedback on the four proposed 2021 Policy Resolutions that will be voted on at the 208th Annual and Collaborative Meeting, on November 6th, 2021. Each VMS member was sent a survey with a unique link to submit your feedback and non-binding comments on the resolutions between August 10th and September 7th, 2021. If you did not receive a link, comments can also be emailed to Voting on the policy resolutions will take place during the live, in-person and virtual VMS Member Business Meeting, Saturday, November 6th from 9am – 12pm.  Click for more information and to register for the virtual 2021 VMS Annual Meeting. 

          2021-2022 Influenza Vaccination Recommendations and Guidance on Coadministration with COVID-19 Vaccines

          CDC COCA Call:

          Thursday, September 9, 2021 at 2pm EST

          Presenters will provide updates on the Advisory Committee on Immunization Practices (ACIP) recommendations for the 2021-2022 influenza vaccination season and guidance for coadministration of influenza and COVID-19 vaccines. Click here to join:

          University of Vermont Project ECHO Enhanced Diagnosis and Management of Dementia by the Primary Care Team This program will discuss evidence-based care, diagnosis, and management of individuals with dementia. The primary target audiences are teams of primary care providers, nurses, and social workers/case managers who work in primary care practices throughout Vermont. The program is inclusive of caregiver roles and aims for person and family-centered dementia care. Participants can receive 1.5 Continuing Medical Education (CME) credits for each learning session attended, up to 13.5 CMEs for the series. This educational series runs from September 16th to May 19th.  This program is free to participants and has limited enrollment. Register here by September 2nd, 2021.

          NEW Webinar: What Health Care Providers Need to Know About Information Sharing and The Info-blocking Regulations

          The Office of the National Coordinator for Health Information Technology (ONC) is hosting a series of webinars to discuss the information blocking requirements of the 21st Century Cures Act. This initial webinar is a physician-focused presentation covering key aspects of their regulations focused on information blocking and provides an opportunity to ask questions and get answers from ONC’s experts. This webinar will be held on September 14, 2021 from 1-2pm EST

          Primary Care Sports Medicine Conference - Virtual

          Thursday, September 16, 2021

          Dr. Kimberly Sikule invites you to attend this virtual conference, designed to update knowledge and skills in the diagnosis and management of common sports medicine problems. Held in conjunction with the Wilderness Medicine Conference, with discounted registration fees for attending both. Registration here, with complete program and accreditation information.

          The 3rd Annual Wilderness Medicine Conference

          Friday, September 17, 2021

          Sugarbush Resort in Warren, VT

          Please join Dr. Kimberly Sikule and other faculty and local experts at the Sugarbush Resort in Warren, VT for in-person, hands-on learning!  Registration here with complete program and accreditation information.  

          See all the Primary Care conferences offered through UVM CMIE this Fall: Questions: Contact Michele Morin at or 802-656-2292.

          Webinar: Technology Creates Calming Environment for Pediatric Mental Health Emergencies

          Thursday, September 23rd, 2021, 1:00 PM - 2:00 PM EST 

          Pediatric emergency department visits for mental health conditions increased significantly during the pandemic — further exacerbating the urgent need for creative solutions for struggling youth. Join Children’s Health in Dallas and Philips and Recornect to learn how environment changes can help de-escalate stressful medical emergencies and how to co-create an innovative solution with technology companies. Register here.

          24th Annual Women’s Health and Cancer Conference: Friday, October 1, 2021

          This free, VIRTUAL educational event is aimed at empowering and supporting individuals and communities with knowledge about cancer prevention, detection, treatment and survivorship. It is for anyone interested in learning more about women’s health and cancer – patients, survivors, health care professionals, caregivers, and the general public. Continuing Education credit can be earned for a small fee.Registration here with complete program and accreditation information Questions: Contact Michele Morin at or 802-656-2292

          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.


          Vermont Medical Society

          134 Main Street

          Montpelier, VT 05602

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