February 14, 2023

NEED TO KNOW

OBGYN Residents Advocacy Day, Shield Law Passes the House and Workplace Violence bill Advances

Last week the full House approved H.89, the House version of the "Shield Law," that aims to provide legal protection for health care clinicians who provide abortion and gender-affirming care services. As part of the OBGYN Residents Advocacy Day, the residents testified in front of the Senate Health and Welfare Committee in support of S.37, the Senate version of the "Shield Law," that focuses on licensing protections, crisis pregnancy centers and insurance coverage. VMS President-Elect Rebecca Bell, MD, testified in the House Health Care Committee on suicide prevention focusing on the efficacy of reducing access to lethal means. The Committee will continue to take testimony and will be discussing actionable items to including in H.230.

After an initial hearing on further extensions and making permanent COVID-19 related regulatory flexibilities, the House Health Care Committee is advancing the bill this week. The House Human Services Committee is taking up several bills of interest this week, including: H.171, a bill that would amend the Adult Protective Services statute, H.190, a bill that would expand the residency requirement for patient choice at end of life and H.222, a bill regarding harm reduction that would reduce prior authorization from Medicaid for MAUD. 

The bill aimed at preventing workplace violence, S.36 passed the Senate Judiciary Committee last week and advances to the Senate Health and Welfare Committee this week. If you would like to testify on the workplace violence bill, please let us know, we also would like to hear from clinicians outside of emergency departments or hospital settings. Email Stephanie at swinters@vtmd.org. Also, please join VMS and VAHHS on February 21st for Workplace Violence Day, in which there will be a Legislative Breakfast, testimony and a press conference. RSVP here.

Action Alert: Urge the Health Care and Appropriations Committees to Increase the Medicaid Fee Schedule

The House Health Care Committee needs to hear from you urging them to include an increase in Medicaid's physician fee schedule (RBRVS or Resource Based Relative Value Scale fee schedule) for their Fiscal Year 2024 Budget recommendations to the House Appropriations Committee. The current Governor’s proposed FY24 Medicaid budget includes NO increase for the physician fee schedule, which with current inflation rates and 2023 Medicare cuts results in an overall cut to primary care practices. Please email both the House Appropriations and House Health Care Committee members to urge them to include at least a 3.8% inflation increase in the FY24 RBRVS fee schedule. 

Practice expenses are up, reimbursement is down, and Medicaid is already one of the lowest payers. Practices are not sustainable with flat payments from Medicaid.

Let lawmakers know how a flat Medicaid fee schedule will impact your practice. The State has said they are working to address access to care and support primary care. The Medicaid RBRVS fee schedule must be increased in the Fiscal Year 2024 Budget just to make up for inflation and multiple fee losses. The Medicare Economic Index (MEI) used by Medicare to measure practice cost inflation was 3.8% for 2022, please ask lawmakers to include a 3.8% inflation increase in the FY24 RBRVS fee schedule.

Please email:

dlanpher@leg.state.vt.us; RScheu@leg.state.vt.us; pbrennan@leg.state.vt.us; tbluemle@leg.state.vt.us; edickinson@leg.state.vt.us; kdolan@leg.state.vt.us; jharrison@leg.state.vt.us; rholcombe@leg.state.vt.us; mmihaly@leg.state.vt.us; wpage@leg.state.vt.us; TSquirrell@leg.state.vt.us; ttoleno@leg.state.vt.us; lhoughton@leg.state.vt.us; fmcfaun@leg.state.vt.us; ablack@leg.state.vt.us; jandriano@leg.state.vt.us; dberbeco@leg.state.vt.us; bcina@leg.state.vt.us; mcordes@leg.state.vt.us; ademar@leg.state.vt.us; bfarlice-rubio@leg.state.vt.us; lgoldman@leg.state.vt.us; apeterson@leg.state.vt.us

VMS Meets with Federal Delegation

VMS President, Ryan Sexton, MD and Executive Director, Jessa Barnard, have headed to Washington, D.C, this week to meet with Vermont’s Congressional Delegation as a part of the American Medical Association National Advocacy Conference. Dr. Sexton will be speaking with the delegation and their health policy staff regarding VMS’ national priorities, such as adjusting Medicare’s physician fee schedule for inflation, funding additional residency slots and addressing violence against health care workers.

Reminder: Premium Pay for Workforce Recruitment and Retention Grants Open through Feb. 27

In March 2022, Governor Scott authorized $60 million for certain health care and social service employers to provide premium pay for workforce recruitment and retention. These funds have been made available to the State of Vermont through the Federal Coronavirus State Fiscal Recovery Fund and Section 9817 of the American Rescue Plan Act.  A second round of funding is now available to applicants, including primary care practices.  Applications are open between February 8 and February 27, 2023.  Practices can receive up to $2000 per FTE, which can then be distributed in a flexible manner, up to the equivalent of $13/hr additional pay per eligible employee.

Program guidance, FAQs and informational webinars are available at: Premium Pay for Workforce Recruitment and Retention | Agency of Human Services (vermont.gov) 

Application Open: Apply for an Intranasal Naloxone Vending Machine

In an ongoing effort to provide evidence-based harm reduction resources to rural communities, UVM CORA has been authorized to distribute five intranasal naloxone vending machines to qualifying health organizations in Vermont, New Hampshire, Maine, and Northern New York.

The overarching goal of this program is to increase access to harm reduction materials for emergency uses and individuals who may not otherwise engage in services. The vending machines provided through this program will be placed in centralized locations in rural communities in Northern New England to provide convenient access to intranasal naloxone.

For more information and to apply, click here.

MISC.

HHS Issues COVID-19 Public Health Emergency Transition Roadmap

As detailed in last week’s VMS Rounds, the Department of Health and Human Services (HHS) is planning for the federal Public Health Emergency (PHE) for COVID-19 to expire at the end of the day on May 11, 2023.  HHS has issued a Health Emergency Transition Roadmap, which outlines which regulatory flexibilities will and will not be changing with the end of the federal PHE.  For example:

• Coverage for COVID-19 testing will change, with the timing and out of pocket expense depending on an individual’s health care coverage
• Many Americans will continue to pay nothing out-of-pocket for the COVID-19 vaccine
• Out-of-pocket expenses for certain treatments may change, depending on an individual’s health care coverage
• Major Medicare and Medicaid telehealth flexibilities will not be affected
• FDA’s EUAs for COVID-19 products (including tests, vaccines, and treatments) will not be affected

See the full Roadmap here.

Resources Available from the UVM Center on Rural Addiction

The UVM Center on Rural Addiction (UVM CORA) is aimed at providing science-based support for rural SUD treatment providers.  Find information on their website about services including  the clinician Office Hours program, offering free and confidential virtual consultation by clinicians with a specialty in the treatment of substance use disorder; an open grant opportunity for intranasal naloxone vending machines; and upcoming trainings on topics such as Fentanyl and Xylazine.  Subscribe to their newsletter at: https://www.uvmcora.org/subscribe/.

Dementia Diagnosis, Treatment and Management for Primary Care Teams

Earn CMEs with a self-paced learning series designed for primary care providers and teams to assist in the early diagnosis of Alzheimer's Disease and Related Dementias (ADRD).

While treatment options for dementia remain limited, numerous prevention strategies have been identified in the literature. In the long-term, prevention can play a key role in curbing the increasing rates of dementia in the U.S.

View the recently added module, Prevention of Dementia, here.

Commissioner of Health Public Health Update on March 2nd

The next Public Health Update call with Commissioner of Health Mark Levine, MD will be on Thursday, March 2nd at 12:30 pm. Hear about the 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.

EVENTS

The UVM CORA Clinician Office Hours

Weekly on Thursdays from 12pm to 1pm ET

This program offers free and confidential consultation from addiction medicine-certified physicians focusing on substance use evaluation and management. Information shared will be general in nature and should not be considered as case-specific medical care.

The UVM CORA Clinician Office Hours program is intended only for healthcare providers or others directly serving people with substance use disorders in HRSA-designated rural areas.

Please complete the form here to register for the Clinician Office Hours sessions held weekly on Thursdays, 12:00 -1:00 pm ET.

Registration will close weekly on Wednesdays at noon.

Vermont Pharmacists Association

February 15, 2023, 7pm to 8pm ET

Virtual

This activity has been designed to address the educational needs of neurologists, emergency room physicians, and hospital clinicians (including hospitalists, nurse practitioners, PAs, and clinical pharmacists). It may also benefit other healthcare providers caring for patients at risk for AIS.

Agenda

• Quick Review: Stroke
• Thrombolysis: 25 Years of Practice Experience Focused on Time
• Newer Thrombolytics: Alteplase Compared With Tenecteplase
• Collaborative Care and Cases
• Q&A

Learning Objectives

Upon completion of this activity, participates should be able to:

• Summarize the latest data from clinical trials of thrombolytic agents used in the treatment of AIS
• Assess the use of collaborative acute care across care settings as it applies to optimal management of patients with suspected AIS

To learn more, click here.To register here.

Indigenous Historical and Intergenerational Trauma Training

for Health/Mental Health Care Providers

February 15 and 22, 2023

Virtual

This training will provide a general overview of indigenous historical and intergenerational trauma and

how this trauma directly impacts the indigenous community’s overall health and wellness.

The presenters for this training will be Kheya Ganguly, the Director of Trauma Prevention and Resilience

Development for the Agency of Human Services and Dr. Frederick Wiseman, a citizen of the Abenaki

Nation of Missisquoi and Coordinator of the Vermont Indigenous Heritage Center.

This training is for all community health and mental health related providers and first responders

View the flyer here.

Click here to join the February 15, 2023 meeting from 1pm to 4pm.

Click here to join the February 22, 2023 meeting from 1pm to 4pm.

Future Health Best: Practices for Advancing Care

March 31, 2023

Virtual and In-person at Waltham, MA

Join physician leaders and health care experts from the Northeast for a signature event to share knowledge and research that advances equitable, sustainable, patient-centered, and best-in-class health care.

You can view the full flyer here.

For more information about the speakers, program, CME accreditation and to register please visit here.

Note: You can use the discount code of FHB23NE when registering for this event 

Save the Dates - Preparing for and Delivering Value-Based Care in Rural Communities

April 4th, May 2nd, June 6th, and June 27th, 2023

View the topics of the webinar series here.

Look for more information and registration details in February 2023 

More conferences from UVM CMIE are expected this Spring to include these topics: Anesthesia, Cardiovascular/Vascular Disease, Geriatrics and Family Medicine. Sign-up to get updates via email for topics that are of interest here

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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