December 5, 2023

NEED TO KNOW

Save the Date for the VMS Advocacy Training on January 11th at 6pm

Attend our Advocacy Training on January 11th and learn about health care legislation likely to advance in 2024 and how you can advocate for policies that will improve Vermont's practice environment. Our virtual training will provide you with all of the information you need to attend one or all of our 2024 Legislative breakfasts being held on select Thursday mornings throughout the upcoming legislative session. We will work off of the VMS toolkit to help you craft an effective advocacy message. Click here for the VMS Advocacy Toolkit

Click here to join the Zoom training: 

https://us02webzoom.us/j/89596651145?pwd-LzgzTThGoEtrQ0Qrc09SeDd4YVNOQTO9

Meeting ID: 895 9665 1145 

Passcode: 964364

VITL Access for VMS Webinar TODAY from 12:15pm to 1pm

This webinar, hosted by VITL in collaboration with the Vermont Medical Society, will serve as in introduction (or reintroduction) to VITLAccess for clinicians. The focus will be how clinicians and staff at hospitals and practices around Vermont are using VITLAccess, and how you and your organization's staff can begin using this tool to access more complete health information about the patients you serve.

This webinar, hosted by VITL, will be held on Tuesday, December 5^th from 12:15-1:00. Register here. A recording will be available to registrants after the session.

Poll Shows Vermonters Overwhelmingly Support Ending the Sale of Flavored Tobacco 

Last week, the Coalition for a Tobacco Free Vermont and Flavors Hook Kids VT Campaign released a new poll indicating that 68% of Vermont voters support ending the sale of all flavored tobacco products. 

Additional data includes the fact that 79% of Vermonters are concerned about the high rates of young people in their communities who are smoking cigarettes, using vapes or other forms of tobacco. These positive poll results come ahead of the 2024 legislative session, during which the House Human Services Committee is scheduled to take up S.18, a bill to end the sale of all flavored tobacco products, including menthol. VMS member, Dr. L.E. Faricy, M.D., pediatric pulmonologist from UVMMC and champion of the bill, was quoted in the press release: "Flavors in tobacco products help introduce kids to nicotine at a critical developmental stage and can be very damaging to brain development. Young people in the state of Vermont deserve to have a good chance of reaching adulthood without being targeted for addiction to substances by corporations.” To learn more about how you can help urge your lawmakers to support this bill email Jill at jsudhoffguerin@vtmd.org and/or click here for more information. 

AMA, VMS Urge Congressional Action to Stop Impending Medicare Cuts

The AMA and national and state medical societies, including the VMS, continue to urge Congress to quickly pass legislation to stop another impending round of Medicare payment cuts.  Absent Congressional intervention, physicians are facing a 3.37 percent payment reduction on January 1, 2024 under the CMS 2024 Physician Payment Schedule Final Rule (MFS). 

The combination of ever-increasing practice costs and long stagnated Medicare payment rates has become unsustainable. When adjusted for inflation in practice costs, Medicare physician pay has declined 26 percent from 2001 to 2023. The Centers for Medicare and Medicaid Services (CMS) recently acknowledged that the cost of running a practice will increase 4.6 percent in 2024, yet physicians are being subjected to a 3.37 percent cut next year.  The medical societies emphasize that if Congress does not act by the end of the year to stop this impending payment cut, many physicians will be forced to reduce available health care services, cut office hours, or even forgo treating Medicare patients altogether. America’s physicians and their patients deserve better. You can take action by contacting Vermont’s Congressional Delegation here.  

Health Reform Oversight Committee Hears Act 167 and AHEAD Model Updates

Last week, the Health Reform Oversight Committee met for the first time since December2021 and heard an update from Owen Foster, the Chair of the Green Mountain Care Board (GMCB), on the hospital system transformation and community engagement process currently being undertaken by the GMCB. Oliver Wyman, the consultants leading the work have just concluded a 6-week community engagement process and they reported over 1800 people participated in community meetings they hosted remotely for each of Vermont's 14 Health Service Areas (HSAs). From now until February 2024 they are in the data synthesis and analysis phase of the study. In March 2024, they plan on bringing recommendations based on this data back to the community for feedback. Click here to read the GMCB report. The Committee also heard an extensive update from Pat Jones, Director of Health Reform at the Agency of Human Services (AHS), on the status of Vermont's current All-Payer Model (APM), and on the new multi-state health reform model being promoted by the Center for Medicare & Medicaid Innovation (CMMI): the AHEAD model. With no option of continuing our current APM, the State is currently evaluating the pros and cons of applying to be in the first two cohorts of the AHEAD model, which would be implemented at the earliest by January 1, 2026. The VMS continues to work directly with AHS to better understand the implications of this new model and its potential impact on primary and hospital care. Click here to read the AHS AHEAD Model report.

Department of Mental Health System of Care Update for November 2023

The Department of Health prepares a monthly progress report for the legislature on current mental health capacity across the state and on initiatives to expand access to care. Click here for November's report, which continues to show very few open beds across the State, particularly youth beds. The report includes the status of Southwestern Vermont Medical Center's (SVMC) proposed 12-bed unit, being designed to treat the mental health needs of children and adolescents. The feasibility study has been completed and SVMC has initiated the CON process. DMH is also moving forward on a Statewide Enhanced Community Mobile Crisis Program, effective January 1, 2024. They will be holding an informational meeting on Tuesday, Dec. 5^th from 2-3pm. Click here to register.

MISC.

Telehealth Billing Reminder

Medicaid providers are reminded that effective 7/1/2023, Vermont Medicaid allows the delivery of audio-only services limited to the defined list of codes that can be found at https://dvha.vermont.gov/providers/telehealth. This list mirrors what Medicare covers and includes additional codes that are clinically appropriate and align with AMA correct coding guidelines.

A review of claims since 7/1/2023 has found that some providers are continuing to bill codes that are no longer allowed as audio-only. Medicaid will consider covering audio-only services that are not on the approved list when unforeseen circumstances require the service to be delivered audio-only however may review such claims for appropriateness. DVHA continues to review telehealth coverage and encourages provider feedback or questions by contacting Gainwell Provider Services at 800-925-1706.

Also effective 1/1/2024, Vermont Medicaid will only allow modifier 93 for audio-only services and no longer allow the use of the V3 modifier. Modifier 93 is available for use on audio claims. Claims billed with the V3 modifier after 1/1/2024 will be denied for incorrect modifier.  Previously, as a response to the Public Health Emergency, Vermont Medicaid temporarily implemented the use of the V3 modifier to signify the service was completed via audio-only for medically necessary, clinically appropriate services delivered by telephone.  

More information and a list of audio-only covered codes can be found on the Department of Vermont Health Access website: https://dvha.vermont.gov/providers/telehealth.

Submit a Resolution to VMS – Help Direct the Work of YOUR Society

VMS welcomes members to submit resolution ideas.  Resolutions set the policy positions of VMS and often drive VMS advocacy work at the state and federal levels.

Resolutions can be submitted on a year-round basis, any time by any VMS member or group of members, including student members. Resolutions are intended to express composite positions of the VMS and are to suggest a significant course of action to be taken by the Society. To see adopted VMS resolutions, click here.

Once a resolution idea is submitted by a member, the resolution will be reviewed by VMS staff, who may assist with further drafting or clarification.  Resolutions are then distributed for comment and non-binding survey to all membership. At a Board meeting after gathering member feedback, the VMS Board will review the resolution and feedback of membership.  All resolutions presented to the Board then require a majority vote of the Board for action, including adoption, amendment or referral.

To submit a resolution idea, please fill out the form, available here or contact jbarnard@vtmd.org for further assistance.

Next Commissioner of Health Call Thursday, January 4, 2024 - December 7th Call Cancelled

The Commissioner of Health, Mark Levine, MD, will hold his next Public Health Update with VMS Members on Thursday, January 4th at 12:30 pm. There will be no call on December 7, 2023.

Hear about  the most pressing public health information affecting the state and nation and have the opportunity to submit questions to Dr. Levine who will answer them, time-permitting. You can join the zoom meetings here.

Commissioner Levine last joined the VMS for a public health update on November 2nd. You can find the notes here.

EVENTS

Cybersecurity Lockdown

December 6, 2023 at 2pm

Virtual

The healthcare industry, from small clinics to large, integrated health systems, is constantly targeted in a variety of highly sophisticated cyber threats and attacks.

Enhancing your awareness of these threats and learning tangible ways to protect your facilities is a team responsibility! We encourage you to join us for an upcoming webinar on Wednesday, December 6 at 2 PM ET with top security expert in the healthcare field, Daniel Schwartz.

This webinar will discuss who is after your data and why you have a professional responsibility to proactively address these threats as well as what you can do today to limit their impact. The webinar will also show a live look at the dark web!

There will be a Q&A session during the webinar.

Learn more and register here.

Emergency Medicine Update

January 16-19, 2024

The Lodge at Spruce Peak, Stowe, VT

Learn more and register here.

35th Annual Eastern Winter Dermatology Conference

February 1-4, 2024

TopNotch Resort, Stowe, VT

Learn more and register here.

Hospital Medicine 2024

February 7-9, 2024

TopNotch Resort, Stowe, VT

The course will provide practical approaches to common problems in hospital medicine informed by experts and the latest evidence. The target audience is comprised of physicians, physician assistants, nurse practitioners, and nurses practicing Hospital Medicine. Some of the clinicians will also be engaged in education, research, quality improvement, and management. The audience may also include Hospital Medicine program administrators, resident physicians, and medical students with an interest in careers in Hospital Medicine. Topics include Congestive Heart Failure; Pain Management; Care of Transgender Patients in Hospital; and more.

Learn more and register here.

Future Health Best: Practices for Advancing Care

March 22, 2024

Virtual and In-Person Waltham, MA

This 2024 conference will focus on the nexus of climate change and its growing impact, AI and new technologies to diagnose and treat patients, and the evolving and expanding role of physicians in this rapidly changing health landscape.

View the event flyer here. Registration will open in January 2024.

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

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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