February 13, 2024

NEED TO KNOW

Help Advocate for Inflationary Increases in the Vermont Medicaid (DVHA) Fee Schedule

VMS and HealthFirst are advocating for a 4.6% inflationary increase over the current 2023 Medicaid rates for the next state fiscal year (beginning June 2024.)  Please reach out to House Health Care committee members to ask for their inclusion of a 4.6% increase for inflation in the Medicaid RBRVS fee schedule in their State Fiscal Year 2025 budget recommendations to the House Appropriations committee.  Please contact them today!  Their recommendations are due to the Appropriations Committee this week.  Your message does not need to be technical – let them know the impact that decreasing Medicaid reimbursement has on your practice and ability to offer services to patients. 

Key Details:

  • The Medicaid RBRVS fee schedule applies to professional services provided by physicians and other clinicians and is determined based on Medicare’s flawed Physician Fee Schedule (PFS).
  • The Medicare Physician Fee Schedule has two problems: it was cut in real dollars effective 1/1/2024 by 3.4% plus does not include any adjustments for inflation (see further description and graphics here). This means that legislative action is needed in the SFY2025 budget to increase at all for inflation.
  • The 4.6% inflationary adjustment requested is equal to the 2024 Medicare Economic Index. This is a federal measure of medical inflation and is adjusted each year.

Contact the committee today at:

LHoughton@leg.state.vt.us; fmcfaun@leg.state.vt.us; ablack@leg.state.vt.us; berbeco@leg.state.vt.us; mcarpenter@leg.state.vt.us; bcina@leg.state.vt.us; mcordes@leg.state.vt.us; ademar@leg.state.vt.us; lgoldman@leg.state.vt.us; apeterson@leg.state.vt.us;bfarlice-rubio@leg.state.vt.us; CNeal@leg.state.vt.us

Crossover Dates are Set and Committees Dig in to Work with Earnest

Last week, the Vermont Legislature announced 2024 crossovers dates - bills will need to pass out of policy committees by March 15th and out of the "money" committees by March 24th in order to advance this session. Any bills that don't make these crossover deadlines are dead for this biennium. In some committees this has led to a flurry of bills being introduced, including H.289, a “Kid's Codebill, which will be introduced in the Senate Economic Development, Housing and General Affairs Committee and aims to require online platforms to put protections in place for kids. In other Committees, they are working on the final drafts of bills in order to vote them out. The House Commerce and Economic Development Committee is expected this week to release a new draft of H.121, an omnibus data privacy bill, incorporating health care data protections from S.173. Jessa Barnard will testify on both H.766, the prior authorization bill, and a House Health Care Committee bill to continue insurance coverage for audio-only telehealth services

Other bills in Committee this week:

  • Committees also continue to dig into the State Fiscal Year 2025 budget and hear testimony from programs seeking state funding. VMS is advocating for a 4.6% inflationary adjustment in the Medicaid professional fee schedule – see the related action alert.  The House Human Services Committee is considering additional funding for skilled nursing facilities.  See this VTDigger Commentary entitled, "A Crisis in Our Emergency Departments," authored by emergency medicine physicians Ben Smith, MD, Julie Vieth, MD, Matthew Siket, MD, and Ryan Sexton, MD calling for support of skilled nursing, long term care and home health. 
  • The Senate Health and Welfare Committee continues to work on S.192, the bill to authorize nine forensic beds at the Vermont State Psychiatric Hospital. 
  • S.18, the bill to end the sale of all flavored tobacco products in Vermont, is stuck in the House Ways and Means Committee over concerns of the revenue loss to the state if retailers cannot sell flavored products. Click here to find your Representatives to email them to urge them to put Vermont kid's health over profit. Click here for Dr. L.E. Faricy's testimony.
  • H.612, a bill to reform the medical cannabis registry program, is up for testimony this week and a new draft that will maintain the potency caps is expected. Click here to hear a VPR story on this topic in which VMS is interviewed.

Seeking Physicians & PAs Interested in Statewide Wellbeing Collaborative

The Vermont Medical Society and LumunosWellBeing are recruiting a team of physicians and PAs interested in improving the well-being of clinicians and medical staffs in the state of Vermont. It is no secret that clinicians are struggling with practicing medicine in today’s environment. For those trying to work on well-being initiatives in their local settings, it can feel particularly isolating.

The Collaborative will meet monthly for 9 months via zoom for one hour at a time. The goals of the Collaborative are:

  1. Learn and share best practices: Drawing from outside guest experts and the experience of those within the group, participants will learn and share ideas for what is working in the field of clinician well being.
  2. Create a Peer Support network: Trying to initiate and sustain well being efforts in local settings is often challenging and lonely work. The Collaborative will provide participants the opportunity of facilitated peer support that will both give ideas to use in local settings, and help sustain them as they continue the work.
  3. Design regional and state wide opportunities for clinician well being: The Collaborative will not only learn, but lead. We will look for new and creative ways to support clinicians in Vermont, particularly focusing on those in under resourced areas.

For more information, see the detailed description here or contact Doug at Doug@Lumunos.org or Jessa at jbarnard@vtmd.org.  

VMSERF Leadership Institute Off to a Strong Start

The 2024 VMS Education and Research Foundation (VMSERF) Leadership Institute kicked off on February 1st & 2nd when the 13 participants in the course came together in person in Burlington and heard from a panel of physician leaders on what they have learned on their leadership journeys and while trying to effect system change.  They are gearing up for a yearlong leadership course, organized by VMSERF and taught by Hanley Center for Health Leadership faculty.  Read more about the course here.

MISC.

Updates to Reportable Disease Rule – Mpox now Reportable

The Department of Health has updated by emergency rule the Reportable and Communicable Diseases Rule.  The updates were effective yesterday, 2/12/24.  The changes: (1) remove the requirement to report negative and indeterminate SARS-CoV-2 results to the Department of Health; 2) Changes the required reporting period for positive SARS-CoV-2 results from "immediately" to "within 24 hours"; 3) Adds the virus Mpox to the list of reportable diseases and the associated laboratory finding, Non-variola Orthopoxvirus, to the list of reportable laboratory findings; 4) Clarifies that immediate reporting for identified diseases and laboratory findings means they must be reported by telephone to the Department.  See the rule here

Next Commissioner of Health Call is March 7, 2024

The Commissioner of Health, Mark Levine, MD, will hold his next Public Health Update with VMS Members on Thursday, March 7th at 12:30 pm. View notes from the February 1st call here.

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.

Financial Education Series for March: Presented by Baystate Financials PLANWell
Each session will be held via zoom at 12:30 p.m. or 5:00 p.m.

SaveWell: Gaining Awareness and Setting Goals - March 12th
Will help you understand your financial goals and the factors that will impact these goals.

InvestWell: Understanding How to Put Savings to Work - March 19th
Gain a clearer picture of how to grow a nest egg by investing it.

LiveWell: Protecting a Fulfulled Life and Retirement - March 26th
Protect your ability to make and save money by looking at how to utilize your assets to prepare for the uncertainties of life after work.


Click Here to Register

VMS February Pet of the Month

Meet Betsy Ross, a member of VMS staff member Birdie Pauley's family. She loves thinking she's a lap dog, but mostly loves to lay on her heated blanket next to Birdie's desk during the cold winter days. You may see Betsy climb into Birdie's chair during a zoom call to say hello to those on screen!

Submit your pet here to be possibly featured next month!

 

EVENTS

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. Learn more and register here.

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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