April 30, 2020


Upcoming Events

 - April 30, 8pm VMS Lumunos Huddle ZOOM

  - Tuesdays, 12:15pm VDH Call Join Skype Meeting 

  - VPQHC Telehealth Events - Click for details

 - May 7, "Medicare Telehealth Coverage" click for details

- May 21, 12-1pm VMS Thursday May Webinar: Optimal Care for Elders in the Time of COVID-19 w/Zail Berry Register

Tell VMS How Telehealth is Working For Your Practice 

The COVID-19 pandemic and the resulting State of Emergency orders have driven the need for Vermont practitioners to provide telehealth services to meet patient's urgent and non-urgent needs. VMS has prepared a brief survey on how telehealth is working for your practice and what barriers VMS can help you overcome in order to provide broader access to quality care during and after Vermont’s State of Emergency has passed. For example, the results of this survey will help inform VMS advocacy for long-term reimbursement of telehealth services and assess if patients need assistance in getting video capability. Please click here for the survey and please submit it by May 15, 2020. 

Please email Jill at jsudhoffguerin@vtmd.org if you have any questions or suggestions.


CMS Announces Expansion of Medicare Telehealth Services

The Centers for Medicare & Medicaid Services today issued another round of sweeping regulatory waivers and rule changes to deliver expanded care to Medicare beneficiaries and provide flexibility to the healthcare system as America reopens. These changes include making it easier for Medicare and Medicaid beneficiaries to get tested for COVID-19 and continuing CMS’s efforts to further expand beneficiaries’ access to telehealth services. Some of the changes include:

  • CMS previously announced that Medicare would pay for certain services conducted by audio-only telephone between beneficiaries and their doctors and other clinicians. Now, CMS is broadening that list to include many behavioral health and patient education services. CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14-$41 to about $46-$110. The payments are retroactive to March 1, 2020.
  • Waiving the video requirement for certain telephone evaluation and management services and adding them to the list of Medicare telehealth services. As a result, Medicare beneficiaries will be able to use an audio-only telephone to get these services.
  • Expanding the types of health care professionals that can furnish distant site telehealth services to include all those that are eligible to bill Medicare for their professional services. This allows health care professionals who were previously ineligible to furnish and bill for Medicare telehealth services, including physical therapists, occupational therapists, speech language pathologists, and others.

For additional background information on the waivers and rule changes see the fact sheet and for more detail click here. VMS will continue to share details about these expansions as they become available.


Legislature Considers Crisis Standards of Care

The House and Senate Health Care Committees held a joint hearing today on crisis standards of care. Kelly Dougherty, Deputy Commissioner, Department of Health, testified regarding the State’s Crisis Standard of Care PlanShe said the section in the Plan on ventilator use is in the process of being updated to add clarity around the factors that can be considered in allocating ventilator use, such as the patient’s prognosis and likelihood of treatment response and the ability of the facility to meet the needs of every patient. A facility would not be able to consider sex, race, ethnicity, sexual orientation, socioeconomic status/ability to pay for care, disability or degree of disability, or chronic disease diagnosis, in and of itself. Many of these decisions would need to be made by a team that does not have information about patient demographics that should not be considered (e.g. race), and there would be an appeals process to reconsider the decision made by the initial team. Cindy Bruzzese, Executive Director and Clinical Ethicist with the Vermont Ethics Network also provided an overview of a number of the criteria and guidelines that can guide clinical decision-making. The Vermont Ethics Network website has a number of resources on allocating scarce resources and the ethical concerns raised by COVID 19.


    Vermont Health Care Associations Release Principles and Guidance for Resuming Patient Care During COVID-19

    The Vermont Association of Hospitals and Health Systems, in collaboration with the Vermont Medical Society, HealthFirst and Bi-State Primary Care, have released guidance for gradually reopening patient care during COVID 19. This Guidance has been submitted to the Agency of Human Services and Department of Health to inform any modifications to the Executive Order suspending non-essential surgical and medical procedures and/or health advisories from the Health Department.  In the meantime, practices can also use the guidance and resources laid out in this document to start informing planning. 


    HHS Will Reimburse For Uninsured Who Received COVID Testing and Care

    As part of the FFCRA and CARES Act, the U.S. Department of Health and Human Services (HHS) will reimburse health care professionals for testing uninsured individuals for COVID-19 and treating uninsured individuals with a COVID-19 diagnosis for dates of service on or after February 4, 2020. HHS has contracted with UnitedHealth Group to administer the HRSA COVID-19 Uninsured Program. Providers can request claims reimbursement through the program electronically and will be reimbursed generally at Medicare rates, subject to available funding and agreeing to program terms and conditions, including agreeing not to balance bill the patient.  Claims can be submitted beginning May 6, 2020.  More information can be found online at http://coviduninsuredclaim.linkhealth.com/


    AMA Urges CMS to Reinstate Advanced Payment Program

    AMA is urging the Centers for Medicare & Medicaid Services (CMS) to reinstate its Accelerated and Advance Payment (AAP) Program and to expand it to cover similar Medicaid retainer payments for the duration of the COVID-19 public health emergency. CMS suspended applications for the AAP on April 26, advising practitioners to apply for the second round of provider relief funds instead. The AMA requests that CMS:

    • Extend the repayment period for physicians to at least two years.
    • Reduce the recoupment amount to a maximum of 25% of claims to ensure that the recoupment process does not result in a future sudden stoppage of Medicare revenue to practices.
    • Waive the interest rate that applies to advance payment balances after the initial repayment period. To learn more click here.


    Verbal Order Now Sufficient for Vermont DNR/COLST

    The Vermont Department of Health has updated the Emergency Medical Services protocol to include that documentation of a clinician’s verbal order for a Do Not Resuscitate/COLST Form is acceptable and should therefore be honored by EMTs.  To document a verbal order, the patient’s nurse or social worker must print the clinician’s name in and write “Verbal Order” on the clinician signature line.  To see the full process that must be followed and the updated instructions on the DNR/COLST form, click here.

    Questions for VDH? VMS Hosts Weekly COVID-19 CALLS With VDH

    Tuesdays 12:15-12:45 pm

    Join Skype Meeting 
    Join by phone: Dial-in number: +1 (802) 552-8456        
    Conference ID: 993815551
    Please join VMS, for a Weekly COVID-19 update from 12:15-12:45 pm hosted by Vermont Department of Health (VDH) Commissioner Mark Levine to update Vermont's clinicians on the latest state information and protocols.

    Click here for the latest VDH Health Alerts

    NGS Upcoming Training Sessions for Medicare Part B Providers

    Do you want to learn more about the CMS Advanced and Accelerated Payment Program or Medicare's Telehealth coverage. National Government Services are offering several educational training sessions and webinars over the next two weeks that could help you and your practice. Click here to see the schedule and to find the registration links.  

    Please click here for the updated UVM Larner College of Medicine CMIE 2020 Conference schedule. 

    The Next Physician & PA Huddle is Thursday, April 29th at 8pm and will be facilitated by David Specht from Lumunos Well-Being
    To Participate: https://zoom.us/j/390844747

    VMS May Webinar: Optimal Care for Elders in the TIme of COVID 19 with Zail Berry, M.D.
    Thursday, May 21, 2020 
    from 12-1PM via ZOOM
    Please preregister 

    Join us for this CME webinar with Zail Berry, MD. We are now offering our monthly webinars for free for all participants and have changed the platform of our webinars to a ZOOM. Please register for this webinar here. You will receive one credit of CME. To see the full schedule and to learn more about the VMS 2019/2020 Monthly Webinar Series that occurs every third Thursday of the month from 12-1PM click here. 

    VPQHC Upcoming Telehealth Events Click here for all upcoming events

    Thursday May 7th, "Medicare Coverage for Telehealth," during the 8-9 a.m. Virtual Office hour. Contact telehealth@vpqhc.org to join

    Telehealth Virtual Office Hours on Wednesdays from 12 pm - 1 pm and Thursdays from 8-9 am. The Wednesday office hour session will be supported by Dr. Mark McGee, current President of Alpine Telehealth. Contact telehealth@vpqhc.org  

    Please let VMS know if you are having issues with any aspect of expanding telehealth services for your practice, including the technology, coding, reimbursement, etc. Contact jsudhoffguerin@vtmd.org



    Vermont Medical Society

    134 Main Street

    PO Box 1457

    Montpelier, VT 05601

    -- Unsubscribe --