September 8, 2020


VMS Survey on Resolutions for 2020 Annual Meeting Closes Friday

VMS will be accepting feedback and non-binding comments on the proposed policy resolutions for the virtual 2020 VMS Annual Meeting until September 11, 2020. These comments, which do not represent a vote, will inform the VMS Council, who will be vetting the proposed resolutions on September 16th, 2020 in preparation of the VMS Member Business Meeting. Voting on the policy resolutions will take place during the live, virtual VMS Member Business Meeting, which takes place on November 7th from 8:30 am - 10:30 am, as part of the virtual 2020 VMS Annual Meeting. This year's meeting, which is held in collaboration with the American Academy of Pediatrics Vermont Chapter, Vermont Academy of Family Physicians and the Vermont Psychiatric Association, will run from 9 am - 5 pm on Saturday, November 7, 2020. Even though we won't be there in-person, the 207th VMS Annual Meeting will provide ample opportunities for meaningful policy work, engaging CME sessions and creative ways to honor your hard-working colleagues. Click for more information and to register for the virtual 2020 VMS Annual Meeting.


Senate Committees Raise Concern with OneCare Vermont’s Reduction to Primary Care Practices

This summer, OneCare Vermont announced that it was making modifications to its payments made to primary care practices for the 2021 contract year. Primary care practices currently receive a $3.25 per member per month “Population Health Management” payment, in addition to fee for service rates, care coordination payments and the chance to earn distributions from a Value Based Incentive Fund. Starting with contract year 2021, OneCare Vermont announced that primary care practices would only receive $1.75 PMPM in Population Health Management payments, with the opportunity to receive up to $4.75 PMPM if the ACO network reaches budget targets at the end of the year. A number of independent primary care practices opposed this reduction in up front payments and stated they would not participate in OneCare based on this change. The issue has come to the attention of the Green Mountain Care Board (GMCB) as well as the Vermont Senate Appropriations and Health & Welfare Committees, which held hearings on the issue last Friday and today.  The Senate Health & Welfare Committee is considering a bill that would prohibit the GMCB from certifying a Vermont ACO that reduces primary care payments. The Green Mountain Care Board is also likely to take the issue up at their weekly Board meeting tomorrow. 


Cannabis Conference Committee Close to Agreement on Marijuana Commercialization Bill

Last Friday afternoon, the S.54 Conference Committee met and came to agreement on a number of sticking points between the House and Senate proposals to create a retail marijuana market in Vermont. The House and Senate agreed the bill will now include:

  • 30% of the cannabis excise tax revenue will be dedicated to funding substance misuse prevention programming, with a cap of $10 million.
  • No advertising or mass marketing will be allowed.
  • A limit on THC and flavored cannabis products is required.
  • Health warnings created by the Cannabis Control Board with oversight by the Department of Health and adopted by rule.
  • No primary enforcement of the use of seat belts.
  • Roadside saliva testing.
  • Medical marijuana registry to move to the Cannabis Control Board.
  • Allowing municipalities the right to opt-in to sales.
  • 6% sales tax to be directed by the Agency of Education to quality afterschool programming.

The Committee adjourned with two points of disagreement related to how the tax revenue would be distributed to municipalities who “opt-in” and whether hemp farmers would qualify for the current use program. The Committee is expected to meet again this week and they are expected to resolve their differences, at which point it will go back to each chamber for the final vote and then advance to the Governor’s desk. The Vermont Medical Society (VMS) and American Academy of Pediatrics, Vermont Chapter (AAPVT) remain opposed to the creation of any non-medical commercial system for retail sales of marijuana because of the negative health impacts on the Vermont population, especially youth and young adults, but appreciate the work by conference committee members to retain many of the public health protections that passed the House in S. 54.


Reminder: Medicare E/M Office Visit Changes Effective Jan 2021

Medicare’s major modifications to coding, documentation, and payment of evaluation and management (E/M) services for office visits will move forward as planned on January 1, 2021.

Key elements of the E/M office visit overhaul include:

  • Eliminating history and physical exam as elements for code selection. While significant to both visit time and medical decision-making, these elements alone should not determine a visit’s code level.
  • Allowing physicians to choose whether their documentation is based on medical decision-making (MDM) or total time. This builds on the movement to better recognize the work involved in non-face-to-face services like care coordination.
  • Modifying MDM criteria to move away from simply adding up tasks to focus on tasks that affect the management of a patient’s condition.

The American Medical Association (AMA) has developed an extensive online library of resources to assist with the transition, which includes the following titles:


VDH Releases “Social Autopsy Report” to Help the State Respond Before Overdose

The Vermont Department of Health (VDH) released the state’s first Social Autopsy Report, which analyzes the interactions of state agencies with Vermonters who later died of a drug-related overdose in order to improve the outcomes of these encounters. The release is in conjunction with the International Opioid Awareness Day. The report examines data from 2017, when 109 Vermonters died of an accidental or undetermined drug overdose and found that nearly all had an interaction with at least one agency in the years before they died (98%). Two-thirds interacted with three or more state agencies, including the Vermont Department for Children and Families and the Department of Vermont Health Access. The analysis was funded through the Centers for Disease Control and Prevention’s Overdose Data to Action grant, in which VDH partnered with the Departments of Corrections, Children and Families, Vermont Health Access (Medicaid), and Public Safety to analyze each department’s relevant data.


AHS Releases Anticipated Timeline for Stabilization Grants

The Agency of Human Services (AHS) informed applicants for the Health Care Provider Stabilization Grant to expect grant payments between September 10 and September 30, 2020. The Agency’s application review period ends September 15, 2020 and each applicant will be notified via email when their funding review has been completed. Applicants will also be able to log into the portal to view the amount of their award, which is intended to cover COVID-19 losses and expenses from March 1, 2020 through June 15, 2020.  Stabilization payments should be received within 7-10 business days after the award notification. The Agency is expected to implement another application period for provider stabilization grants later this fall. Click here for more information.

NEW! 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. 

NEW! Once a month, VMS has a guest speaker during this call time, as the Commissioner has a conflict. On September 17th, please join with the regular call login information at 12:00 p.m. for the VMS Thursday webinar, MOUD Modifications in a COVID-19 World.

Join Zoom Meeting -

Meeting ID: 867 2625 3105 / Password: 540684

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


AAP VT and VDH Offer Grants for Flu Vaccination Expansion

The American Academy of Pediatrics Vermont Chapter, in collaboration with the Department of Health’s Immunization Program, is providing funding to support expanded influenza vaccination by healthcare practitioners or organizations. In an effort to decrease the incidence of respiratory disease throughout the state of Vermont, healthcare practitioners are encouraged to offer expanded services to increase influenza coverage, including, but not limited to, longer hours or designated flu hours, off-site clinics, or additional staffing.

Health Care Practices/Organizations may retrospectively receive $1000 per clinic held (up to $5000 total). Applications will be reviewed on receipt and funds will be distributed upon project completion and receipt of final project report. Applications must be received by October 23rd, 2020.  Flu Clinics will ideally be held before the end of the year, but must be completed by March 31, 2021. If would like to apply for the grant, please complete this application and email back to me at


Apply Today! VMS Physician Executive Leadership Institute Accepting Applications

Perhaps never before have physicians and PAs been asked to step up and skillfully lead rapid change than they have throughout the COVID-19 pandemic. Every clinician has brought her or his leadership and management styles and skills to the forefront to ensure the best outcomes for Vermont patients. The VMS Education & Research Foundation is pleased to announce it is now accepting applications for its experiential Executive Leadership Institute, which will enhance and fine-tune the most important leadership skills and concepts for a statewide cohort of Vermont physicians and PAs. Applications will be accepted through September 18th, and the 40-hour, year-long course begins in November. Click here for more information.


CMS Adds to Restrictions to Medicare Beneficiary COVID 19 Testing

Last week, CMS announced a new round of sweeping regulatory changes that affect numerous provider types. Among them, the revised policy specifies that each Medicare beneficiary may receive one COVID-19 test without the order of a physician or other health practitioner, but Medicare will require such an order for all further COVID-19 tests. This change was enacted to help ensure that beneficiaries receive appropriate medical attention if they need multiple tests. It is also designed to stop fraudsters from performing or billing for unnecessary tests. Click to view the new rule.


VMS Launches 2020-2021 Third Thursday Webinar Series

Please join us Thursday, September 17th at 12 p.m. for the first webinar in the new VMS 2020-2021 Third Thursday Webinar Series, entitled, MOUD Modifications in a COVID-19 World, with Tony Folland, from the Vermont State Opioid Treatment Authority (SOTA). MOUD is almost universally identified as a lifesaving intervention however COVID-19 has required practitioners to reconsider how to initiate care, monitor treatment responses, and modify treatment plans while minimizing face to face contact. We will discuss the regulatory and clinical opportunities and challenges, and lessons learned to date.

Join Zoom Meeting -

Meeting ID: 867 2625 3105 / Password: 540684

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

VMSERF Online Silent Auction

Do you have an item, skill, or activity you’d be willing to donate to the Vermont Medical Society Education and Research Foundation (VMSERF) silent online auction? Help VMS President Cathy Schneider, M.D., and President-elect Simha Ravven, M.D., support fellow members during this challenging year through a silent auction. Your creative and generous donations will be directed to VMSERF, a 501(c)(3) nonprofit sponsored by the Vermont Medical Society, and organized to support charitable, educational and scientific activities in the field of health. If you would like to donate, please complete this form by September 14th. The auction will take place online on 32Auctions between October 28th and November 4th. PIease contact Elizabeth Alessi with questions at

RME Collaborative’s 2020 Rural Health Clinical Congress

Saturday, Nov. 21, 2020

9 a.m. EST

An interactive, multi-topic, complimentary CME/CE conference held in conjunction with National Rural Health Day, designed for primary care providers who care for patients in rural and underserved areas. Click here to learn more and register 


The Vermont Board of Medical Practice is pleased to announce it will again partner with the Boston University School of Medicine to present an online version of the award-winning SCOPE of Pain CME course. “SCOPE” stands for Safer/Competent Opioid Prescribing Education and satisfies Vermont's requirement for all healthcare professionals who register with the DEA to prescribe controlled substances to earn at least two hours of CME on opioid prescribing. 

Wednesday, September 23, 2020

6:00 p.m. - 8:30 p.m. EST

Register here

OneCare–COVID Update & Impact on those with Respiratory Conditions (Dr. Levine)

Friday, September 11, 2020

2:00 p.m. - 3:00 p.m. EST

Register here


Vermont Medical Society

134 Main Street

PO Box 1457

Montpelier, VT 05601

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