November 26, 2024

NEED TO KNOW

In this season of thanksgiving, the VMS staff express our gratitude for our members.   We recognize that you sacrifice time with your family, friends and relatives to care for the most vulnerable in our communities.  You give endless hours not only for patient care but for strengthening your organizations, giving back to the community, supporting VMS, documentation and paperwork, and trying to improve our healthcare system in face of what can feel like unsurmountable headwinds.  Thank you for your dedication, passion, and optimism. 

We also recognize that the holiday season can bring stress and challenges.  If you or your colleagues need support, please remember that Colleen and Dr. Nels Kloster with the Vermont Practitioner Program are here to give confidential referrals to community resources and that VMS partners with Doug Wysockey Johnson to bring members free wellbeing workshops and executive coaching sessions. 

Wishing you the best and please let us know if there is anything more we can do to support you. 

- From the VMS Staff, Jessa, Stephanie, Colleen and Birdie

VMS, Specialty Societies, Release Statement Regarding Trump Administration Appointees

As incoming President Donald Trump continues to announce nominations for key health care positions, VMS and a number of state specialty societies have released a statement urging the US Senate to prioritize nominees who value evidence-based science, support medical and scientific advancement, and refute disproven and dangerous conspiracy theories.   The statement also calls on reviewing candidates for their support of established VMS policies such as ensuring a robust evidence-based public health system; supporting universal access to comprehensive, affordable, high-quality health care; and supporting access to vaccines, gender affirming healthcare and reproductive health care.   In recent days, Trump has announced a number of nominees including Robert F. Kennedy for HHS Secretary, Dr. Mehmet Oz for CMS administrator, Florida Rep. Dave Weldon for Director of the CDC, Dr. Janette Nesheiwat as Surgeon General and Dr. Marty Makary as Commissioner of the FDA.  Read the VMS and specialty society statement here.  Read more analysis about the nominees in articles here, here and here.

Vermonters wanting to weigh in on the appointments, should contact Senator Sanders at: https://www.sanders.senate.gov/contact/contact-form/ and Welch at: https://www.welch.senate.gov/email-peter/#email-peter

For more information on Senate hearings to consider nominations in 2025, please visit the Senate Finance Committee webpage and the Senate Health, Education, Labor and Pensions Committee webpage.

Health Care Costs Continue to Lead the News

The recent announcement from the UVMHN to reduce services continues to receive media attention; advocates have been particularly focused on the closure of CVMC’s in-patient psychiatric unit.  Members of the Vermont Psychiatric Association met with members of the CVMC administration and UVMHN Psychiatry Department last week to discuss the closure, and released a statement today opposing closing the 8-bed unit. See the statement here.

The announced service closures come close on the heals of the Act 167 report, hospital budget season, and rising school budgets impacted by health insurance costs, adding to the sense that Vermont’s health care system requires urgent change.  VMS leaders have been meeting with representatives of the administration and Green Mountain Care Board to discuss ways to ensure clinical input is taken into consideration with reform efforts.  Coming into the legislative session, the Health Reform Oversight Committee, a committee made up of both House and Senate members from a range of committees including health care and finance, will be meeting from 10am-2pm on December 6th at the statehouse and via zoom.   Owen Foster, chair of the Green Mountain Care Board, and Jenney Samuelson, Secretary of AHS, will be discussing the Act 167 Report as well as the AHEAD Model. See the agenda here.  AHS and the GMCB are no longer planning a joint public meeting to receive comments on the Act 167 Report.

Increase in Cases of Pneumonia

The Vermont Department of Health has been notified by Vermont health care providers and schools of an increase in cases of pneumonia. Many of these cases are suspected or confirmed to be caused by Mycoplasma pneumoniae. The CDC is monitoring the increase in these cases nationally, especially in young children, and issued a bulletin: Mycoplasma Pneumoniae Infections Have Been Increasing | NCIRD | CDC.

Requested Actions

  • Have increased suspicion of pneumoniae among patients with community-acquired pneumonia who aren't clinically improving on antibiotics.
  • Review CDC’s treatment strategies and guidance for this infection. Consider empiric treatment with azithromycin if clinical history and symptoms are concerning for pneumonia and diagnostic testing is not feasible or timely.
  • Promote the judicious use of antibiotics and minimize the risk of antibiotic resistance by not prescribing antibiotics unless indicated by clinical and/or laboratory evidence.
  • Pursue clinical assessment and treatment for other respiratory conditions, regardless of testing for pneumoniae, as other conditions continue to circulate.
  • Promote strategies to prevent respiratory illness, including getting vaccinated.
  • Assess vaccination history and ensure your patients are up to date with COVID-19, influenza and pneumococcal immunizations that help protect against respiratory illnesses as we enter the winter season. Pneumococcal vaccines are now recommended for adults aged 50 or older and children under 5 years of age.
  • Report any unexpected pattern or cluster of illness to the Health Department by calling the Infectious Disease Epidemiology program at 802-863-7240, option 2. Individual cases of pneumoniae are not reportable to the Department.

Read full Health Advisory here.

 

Senator Welch Leads Letter on Addressing Medicare Payment Cuts

As physicians face another year of cuts stemming from the Medicare Physician Fee Schedule, 41 Senators cosigned a letter urging the Senate to address cuts before end of year.  Thanks to Senator Peter Welch, along with Senator John Boozman, who led the effort to author the letter and reach out to Senate offices for support.  See the full letter here.

MISC.

Change to Prior Authorization Requirements for Re/habilitation Therapies for Medicaid Beneficiaries

Effective 1/1/25, there will be no prior authorization requirement for Medicaid-covered outpatient physical therapy (PT), occupational therapy (OT), and speech language pathology (ST) services for Vermont Medicaid members under the age of 21. For adult members, the threshold for combined outpatient PT/OT/ST services per calendar year will increase from 30 to 60 visits per calendar year before prior authorization is required. For helpful resources, utilize the VT Medicaid portal https://vtmedicaid.com/#/home to find: https://dvha.vermont.gov/providers/clinical-practice-guidelines; https://dvha.vermont.gov/forms-manuals; https://www.vtmedicaid.com/#/providerEducation; and https://www.vtmedicaid.com/#/feeSchedule.

Feedback Sought: Complementary and Alternative Medical Approaches in MH and SUD Treatment

A specialized QI facilitator for the Blueprint, naturopathic physician Monique Thompson, has recently completed a literature review on complementary and alternative medical (CAM) approaches to depression, anxiety and substance use disorders. The document is intended to enhance provider and clinician knowledge on CAM therapies and provide strategic insight for integration into clinical practice. It can be found here on the Blueprint website. The document is currently open for review, comment and feedback.  Please share questions or feedback directly with Monique at Monique.Thompson@partner.vermont.gov.

Reminder Vermont MD Licenses Expire November 30th 

A reminder to all MD members that MD licenses expire on November 30th of this year.  If you did not already submit your renewal by November 16th it may not be able to be processed before the November 30th expiration date.  Any license issued prior to September 1st of this year will also expire on November 30th.  For more information, including CME hour requirements for 2024 and CME FAQs, see the Board of Medical Practice website, here: https://www.healthvermont.gov/systems/board-medical-practice/applications-licensing-and-fees.   For information on no- or low- cost courses that meet the CME requirements, see the VMS CME webpage here: https://vtmd.org/cme-requirements-and-course-resources.

Vermont Clinician Prior Authorization Impact Survey Still Open

VMS has launched a survey to inform policy makers regarding the impact of prior authorizations on your health care facility/practice and patients. This survey was requested by the Vermont legislature in Section 7(a) of Act 111 of 2024 to measure the impact of the law on prior authorizations both before and after the law goes into effect on January 1. Thank you in advance for your assistance in completing the survey! Your input is very important!  Contact the Vermont Medical Society with questions at https://vtmd.org/contact-us.

Please find the links below. 

Clinician Survey Link. Intended for clinicians who participate in the prior authorization process.

Practice Administrator Link. Please have the practice or facility staff familiar with the prior authorization process and staffing at your location complete this survey for your practice. Please only complete once per facility/practice.

Next Commissioner Call, December 5, 2024

The Commissioner of Health, Mark Levine, MD, will hold his next Public Health Update with VMS Members Thursday, December 5th at 12:30 pm. You can join the zoom meetings here.

He held his most recent VMS member call on November 7th. Notes from the call are here.

EVENTS

Learning Collaboratives on In-Basket Reduction and Reducing Regulatory Burden

October 2024 – March 2025

AMA STEPS Forward® Innovation Academy is launching two new, six-month learning collaboratives on optimizing the in-basket to reduce work burden and rethinking how organizations apply regulatory rules to clinical practice. Each collaborative will convene dyads or triads of leadership representatives from multiple organizations to engage in a longitudinal shared learning experience. Limited space available. Learn more.

For more information about offerings from UVM CMIE, visit here.

VTMD.ORG

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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