November 9th, 2021


208th Annual VMS Meeting: A Celebration of Members' Service During Pandemic

The 208th Annual VMS Meeting was held this weekend and although it was virtual, the weekend was filled with educational content, valuable time with colleagues, policy-setting and opportunities to honor physicians and other health care leaders across the state. VMS’ Annual meeting, hosted in collaboration with the American Academy of Pediatrics Vermont Chapter, the Vermont Academy of Family Physicians and the Vermont Psychiatric Association, was a celebration of the unwavering commitment Vermont clinicians have to their practice and to the deep connection VMS members have with each other. VMS President Simi Ravven, MD, led the second virtual VMS Business Meeting, and successfully stewarded debate and voting on four policy resolutions focused on equitable access to audio-only telehealth services, primary care, home health and hospice services, pediatric mental health services, and adoption of updated VMS Bylaws. The Awards Ceremony honored nine awardees this year, or eleven if you count the impromptu appreciation for Stephanie Winters that occurred during the event. VMS members also elected the slate of Society officers for 2022 including: as VMS President for a second term, Simha Ravven, MD (Psychiatry, Howard Center); as President-Elect, Ryan Sexton, MD (Emergency Medicine, NVRH) and as Vice-President Rebecca Bell (Pediatrics, UVMMC). Afternoon CME sessions provided clinical insight on issues of health equity and the latest on COVID-19. Please watch your email for a Green Mountain Physician edition dedicated to the meeting, including award winners, adopted policies, recordings of the CME sessions, photos and more highlights from the day. Thank you to everyone who has continued to work tirelessly for all of the citizens of Vermont through this pandemic and to all who contributed to the massive success of this meeting!


Open for Member Comment: VMS Position On Commercialized Sales of Cannabis

The VMS Council will be considering an updated position on commercialized sales of cannabis at their November 17th Council meeting. All members are encouraged to submit feedback on the resolution here by 12pm on November 16th. The Resolution would replace VMS’ 2018 resolution Opposing a System of Commercialized Sales of Recreational Marijuana.

Members interested in attending the Council meeting on the 17th from 6:30-8:30 pm via zoom should contact Birdie Pauley at


Vermont Continues Roll Out of Pediatric Pfizer Vaccine; COVID-19 Updates 

At the Administration’s press conference today, Governor Scott stated that over 14,300 children ages 5-11 had registered or received their first dose of the pediatric COVID-19 Pfizer vaccine as of Tuesday morning. This is approximately 30% of the age group and places Vermont at the highest rates of registration in the country. Because of this, Vermont requested and was grated from the White House an additional 3900 pediatric doses for next week, bringing the total doses for next week to 9,000. Earlier today, VDH also stated that because of the high demand and limited supply it is unclear if primary care practices will be able to begin ordering pediatric doses for office administration on Wednesday. VDH will continue to keep practices informed. 5-11 year olds are currently seeing the highest rate of COVID-19 cases in the state, driving the need for vaccination as soon as possible. Overall, Vermont had a 42% increase in cases over the past 7 days and does not predict a decrease within the next 4 weeks. Administration officials also urged all adults to get booster doses, and reiterated that any adult who feels exposed to COVID-19 through work or the community is eligible for a booster. Healthcare workers were urged to volunteer with the Medical Reserve Corps to help staff vaccination clinics. Notes from the press conference can be found here and the weekly DFR Modeling Report here. Notes from VMS and Hospital Association calls with Commissioner of Health Mark Levine, MD, can be found here.

AAP-Vermont is hosting clinical conversations for parents and caregivers to learn about the vaccine and ask questions. Click here for details.

Pfizer Vaccines US Medical Affairs continues to host daily Medical Updates & Immunization Site Training for All Providers with a Focus on Emergency Use Authorization of the Pfizer-BioNTech COVID-19 Vaccine for Children 5 through 11 Years of Age. 

 Date & Time


Attendee link – November 9 – 5 PM ET 


Attendee link – November 10 – 12 PM ET 


Attendee link – November 11 – 12 PM ET 


Attendee link – November 12 – 12 PM ET 


Attendee link – November 15 – 5 PM ET 


Attendee link – November 16 – 5 PM ET 


Attendee link – November 17 – 12 PM ET 


Attendee link – November 18 – 12 PM ET 


Attendee link – November 19 – 12 PM ET 


Attendee link – November 22 – 5 PM ET 


Attendee link – November 23 – 5 PM ET


Attendee link – November 24 – 12 PM ET




    CMS Releases Final Rule for CY 2022 Medicare Physician Fee Schedule

    Last week, the Centers for Medicare & Medicaid Services (CMS) released the final rule for the CY 2022 Medicare physician fee scheduleIn a statement after the rule’s release, American Medical Association President Dr. Gerald Harmon noted that the rule confirms the cuts that are in store that Congress must address before the end of the year. Notably, the 2022 Medicare conversion factor will be reduced by approximately 3.85% from 34.8931 (2021) to 33.5983. This is largely a result of the expiration of a 3.75% increase to the conversion factor at the end of calendar year 2021, as averted in 2021 by Congressional action.

    Additionally, CMS finalized provisions that extend coverage of services that were added to the Medicare telehealth list on an interim basis in response to the COVID-19 PHE until the end of 2023 and eliminated geographic barriers, allowing patients in their homes to access telehealth services for diagnosis, evaluation and treatment of mental health disorders. CMS also announced plans to permanently increase payment for immunization administration, beyond COVID vaccines and relied on information from the AMA and the RUC in developing the improved payment rates. CMS is also moving forward with the first round of seven MIPS Value Pathways (MVPs) that will be available, beginning with the 2023 performance year.


    Health Care and Large Employer Vaccine Mandate Rules Released – Compliance Required by Jan. 4

    On Thursday, Nov. 4th the Centers for Medicare & Medicaid Services (CMS) released emergency regulations requiring COVID-19 vaccination of eligible staff at health care facilities that participate in the Medicare and Medicaid programs. Facilities covered by the regulation must establish a policy ensuring all eligible staff have received the first dose of a two-dose COVID-19 vaccine or a one-dose COVID-19 vaccine prior to providing any care, treatment, or other services by December 5, 2021. Staff must have received the necessary shots to be fully vaccinated by January 4, 2022. The regulation also provides for exemptions based on recognized medical conditions or religious beliefs but the regulation requires staff vaccination only and does not provide for a testing alternative. The regulation applies to Medicare and Medicaid-certified provider and supplier types that are subject to CMS health and safety regulations such as hospitals, nursing homes, dialysis centers and ambulatory surgical centers  but not to independent physician practices. CMS will enforce the mandate through routine inspections, or surveys, of the facilities that participate in the federal insurance programs.  See the press release, FAQs and the full rule here.

    Also on November 4th, the Occupational Safety and Health Administration (OSHA) finalized Emergency Temporary Standard (ETS) rules that include binding requirements for all employers with a total of 100 or more employees to implement a mandatory COVID-19 vaccination policy, with an exception for unvaccinated employees who undergo regular COVID-19 testing and wear a face covering at work.  Click here for the full rule, factsheets, webinars and employee information.   The mandate will take effect January 4thMultiple lawsuits have been filed to challenge this requirement and on Saturday, a panel of the U.S. Court of Appeals for the Fifth Circuit in Louisiana temporarily blocked the mandate. But the block doesn't have an immediate effect, the press has reported, since the first major deadline in the rule is Dec. 5 and it is unclear what further legal actions will have taken place by then.

    These latest regulations are in addition to the  Health Care ETS released in June for health care settings “where suspected or confirmed COVID-19 patients are treated.” This regulation requires COVID-19 mitigation steps to be taken by many health care entities, such as implementing a COVID-19 plan, patient screening and record keeping requirements. For more information see the “Is your workplace covered by the COVID-19 Healthcare ETS?” flow chart and the fact sheets, sample check lists and other materials here.


    Physician Executive Leadership Institute - Accepting Applications!

    The Vermont Medical Society Education & Research Foundation (VMSERF) is proud to announce its third statewide Physician Executive Leadership Institute Foundational Course to begin in winter 2022! This course is offered in partnership with the Daniel Hanley Center for Health Leadership and Lumunos.

    Physicians and PAs have been asked to step up and skillfully lead rapid change throughout the COVID-19 pandemic. Every clinician brought their leadership, management styles, and skills to the forefront to ensure the best outcomes for Vermont patients. VMSERF is pleased to continue an experiential learning opportunity that will enhance and fine-tune the most important leadership skills and concepts for a statewide cohort of Vermont physicians and PAs.

    To learn more details about the 2022 course, the curriculum, and how to apply, click here or contact Applications are due November 19th.



    Please join us for a conversation about COVID-19 vaccines for children. Find the forum dates here.

    Financial Planning Highlights for Residents, Fellows, and New Attending Physicians

    November 16th 7-8pm, ET

    Pastore Financial Group, LLC are bringing back their Complimentary Financial Educational Webinar Series for Physicians that will cover:

    • Model and project cash flow needs for retirement income
    • Align investment allocation with retirement goals
    • Mitigate estate transfer taxes and costs
    • Effectively manage income taxes in retirement
    • Maximize Social Security benefits
    • Organize your finances using technology so you can make informed financial decisions
    Register here.

    Financial Planning Highlights for Residents, Fellows, and New Attending Physicians

    November 18th 7-8pm, ET

    Pastore Financial Group, LLC are bringing back their Complimentary Financial Educational Webinar Series for Physicians that will cover:

    • Understand the pro’s and cons of loan forgiveness and loan repayment
    • Consider protecting your income for yourself as well as your family
    • Understand the ins and outs of individual disability insurance
    • Set financial goals and priorities for your finances the early years of your career
    • Organize your finances using technology so you can make informed financial decisions
    Register here.

    The Michael Herschorn Symposium: Parkinson’s Disease and Movement Disorders in Primary Care - Virtual

    November 19th, 9am - 2:15pm

    The Binter Center for Parkinson’s Disease and Movement Disorders invites you to attend this virtual symposium which will provide you with the tools you need to diagnose and treat patients with various movement disorders, and to know when referrals may be needed.

    Topics include: Diagnosing PD, Treatment Options for Early and Advanced PD, Cognitive and Psychiatric Manifestations of PD, Diagnosing other common movement and gait disorders such as Essential Tremor, NPH, RLS, Drug-Induced Movement Disorders, and more.

    To register, view the complete program and accreditation information, click here.


    Vermont Medical Society

    134 Main Street

    Montpelier, VT 05602

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