November 16th, 2021

NEED TO KNOW

Join the VMS for a COVID-19 Clinical Conversation THIS Thursday!

Join us this Thursday, and every 3rd Thursday of the month, from 12:30pm to 1pm for a clinical conversation relevant to COVID-19. 

This week we will focus on an update on vaccinations in the state - including boosters & pediatric vaccine uptake, distribution and state allocation – as well as COVID 19 trends, oral antiviral treatments, and expanded booster eligibility.  Come with your questions and hear from our immunization department as well as Vermont physician leader – Dr. Trey Dobson. 

Join the call from 12:30pm to 1pm this Thursday, November 18th, by clicking here.

Thank you for Providing Member Comment on the 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. 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 bpauley@vtmd.org

Governor Scott Offers Special Session During Thanksgiving Week for Mask Mandate Compromise and Press Conference Notes

Yesterday, Governor Scott issued a letter providing Vermont’s legislative leadership with an opportunity to call a special legislative session for lawmakers to vote on whether individual municipalities in the State should have the authority to mandate the use of facial coverings indoors within their jurisdictions. The letter comes after repeated calls by Senate President Pro Tem Becca Balint and House Speaker Jill Krowinski for Governor Scott to provide broader protection for Vermonters from the COVID-19 Delta surge through a statewide mask mandate. The Governor cited "differences of opinion" on both how to the end the pandemic and the uses of gubernatorial power and stated that the authority to adopt a mask mandate would be time-limited, would not include schools and would need to be voted on whether to rescind on a month-by-month basis. The Senate President and House Speaker were disappointed that the Governor was not willing to take statewide action, but indicated they would be willing to call lawmakers into special session on Monday, Nov. 22nd. Read more in VTDigger. 

To read the notes from today's press conference, please click here.

MISC.

Physician Executive Leadership Institute - Accepting Applications until FRIDAY!

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 swinters@vtmd.org. Applications are due November 19th.


OneCare VT Emphasizes Primary Care and Care Coordination in 2022 Budget Presentation

Last Thursday, OneCare VT (OCVT) presented its 2022 proposed Budget to the Green Mountain Care Board (GMCB). The budget proposal laid out this year's methodology for continuing OCVT’s progress towards converting fee-for-service payments to value-based-care, reporting that $1.3 billion or roughly half of Vermont's eligible health care spend is in the model. OCVT said that statewide attribution to Vermont's All-Payer Model is growing with 288,000 lives and currently over 5,000 providers participating, including approximately 90 percent of Vermont's eligible primary care providers. OCVT intends to continue to increase their focus on primary care based on listening sessions with practices they held throughout the summer and fall. The 2022 budget includes an expansion of the Comprehensive Payment Reform (CPR) program for primary care practices and overall spend on primary care. Care coordination is prioritized but they will no longer require that all practices use OCVT's Care Navigator platform, instead allowing practices to use the care management platform that works best for them.  The GMCB is accepting public comment on the 2022 OCVT Budget until Dec.1, 2021 and will vote on whether to adopt the budget by the end of the year. Click here for the presentation. 

Molly Gray's Recover Stronger Together Agenda Calls for Increased Mental Health Reimbursement

Lt. Governor Molly Gray held a press conference yesterday announcing her "Recover Stronger Together Agenda" for the 2022 Legislative Session. Her press conference directly followed Senator Patrick Leahy's announcement that he would be retiring after nearly 5 decades in office. Gray said that she developed five focus areas in her agenda in response to a listening tour in which she reportedly met with over 100 Vermonters and 60 different organizations, including the Vermont Medical Society. The agenda focus areas include: 

  • Workforce Development
  • Housing
  • Child Care/Paid Family and Medical Leave
  • Mental Health 
  • High-Speed Internet/Broadband

Updates from Special Meeting of the AMA House of Delegates

The American Medical Association (AMA) announced policies adopted yesterday and today by physician and medical student leaders from all corners of medicine during voting at the all-virtual Special Meeting of the AMA House of Delegates. Policies adopted help the AMA drive the future of medicine, remove obstacles that interfere with patient care, and improve the health of the nation.  Click here for an overview of the adopted policies.

The AMA’s House of Delegates is the policy-making body at the center of American medicine, bringing together an inclusive group of physicians, residents and medical students representing every state and medical field. Vermont is represented by Delegate Norm Ward, MD, and Alternate Delegate Catherine Schneider, MD. 

CMS to Apply MIPS Automatic Extreme and Uncontrollable Circumstances Policy for the 2021 Performance Year

Due to ongoing discussions and advocacy the AMA has being having with CMS on the impact the COVID-19-PHE is having on physician practices, CMS will apply the Automatic Extreme and Uncontrollable Circumstances Exemption Policy (EUC) for the 2021 MIPS performance year. This 2021 policy change recognizes the continued challenges physicians face with providing care during the PHE and reduces administrative burden. Therefore, if a physician participates in MIPS as an individual, they don’t need to take any action to have the automatic EUC policy applied to them. CMS will automatically identify and re-weight all 4 MIPS performance categories reweighted to 0% and receive a neutral payment adjustment for the 2023 MIPS payment year unless the physician 1) submit data in 2 or more performance categories, or 2) have a higher final score from group or APM Entity participation.

Unfortunately, due to a systems issue if a physician or small practice participates in the 2021 MIPS program by submitting Part B quality measures through claims and has submitted quality data codes on their 2021 Medicare claims, they will need to still file a 2021 MIPS Hardship EUC to avoid a 2023 payment adjustment and be exempt from the 2021 MIPS program. If the physician or practice has not submitted any 2021 MIPS performance data, then the automatic EUC will apply to the physician.  For more detailed information on the automatic EUC policy and CMS announcement, please click here.

AMA Summary of CY 2022 PFS Final Rule Now Available

Please click here for the American Medical Association (AMA) summary of the CY 2022 Physician Fee Schedule (PFS) final rule released by the Centers for Medicare and Medicaid Services (CMS) on November 3, 2021. The policies in the rule are scheduled to take effect on January 1, 2022 and cover diverse topics, including the CY 2022 rate setting and Medicare conversion factor, telehealth and other services involving communications technology, and updates to the Quality Payment Program (QPP) through Merit-based Incentive Payment System (MIPS) activities, methodology, and payment adjustments, among other provisions.

Updated Information Regarding COVID-19 Monoclonal Antibodies

This update is to remind providers of the NIH COVID-19 Treatment Guidelines Panel’s recommendations regarding the use of monoclonal antibodies, and to encourage their use for patients who could benefit from them. This is of special relevance at this time of Delta surge in light of this treatment’s potential to prevent hospitalization and protect healthcare system capacity.

Three prior health updates regarding COVID-19 monoclonal antibodies (mAbs) have been issued:

  1. The March 3, 2021 Health Update provided links to two sets of national guidelines regarding the use of COVID-19 mAbs for the treatment of COVID-19 (from the Infectious Disease Society of America (IDSA) and from the National Institutes of Health (NIH) ). These guidelines are updated regularly.
  2. The April 5, 2021 Health Update gave further information from the national guidelines regarding the use of mAbs for treatment of COVID-19.  
  3. The August 9, 2021 Health Update addressed the use of COVID-19 mAbs for post-exposure prophylaxis. Administration via the intravenous route was addressed (as used for treatment of COVID-19) along with subcutaneous administration.

To read the full update, click here.

EVENTS

Please join us for a conversation about COVID-19 vaccines for children. Find the forum dates here. To view recordings from previous forums, click here.

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

December 7th 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

December 9th 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.

VTMD.ORG

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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