March 11, 2025

NEED TO KNOW

Legislative Committees Pushing Towards “Crossover”

With the legislature starting its final week before crossover – the date by which most bills have to be voted out of their policy committees – it was a very busy week at the statehouse before Town Meeting week and will be very busy with committee testimony and votes this week. Here is an update on some key issues:

VMS, AAP-VT and VTAFP have been at the forefront of advocating for funding for primary care for the 2026 “gap year” between the end of the ACO and start of the AHEAD Model. We were successful in having this funding added as one of the top recommendations from the House Health Care Committee to the Appropriations Committee before Town Meeting week. This will be an ongoing push throughout the session as the budget asks still need to go through a number of more stops in both the House and Senate.
As described further in the article below, the Senate Health and Welfare Committee is diving into a committee health reform bill. VMS testified on an earlier draft of this bill (testimony here) and will testify again on this version tomorrow.
An update to Vermont’s shield laws to protect patients and providers of reproductive and transgender health care services, S. 28, passed out of the Senate Health and Welfare Committee on Friday the 28th. VMS supports this bill and advocated for ways to strengthen it before passage, including excluding from public records requests the private contact information contained in licensing applications.
The bill to allow optometrists to perform eye surgery received a heated hearing in the Senate Government Operations Committee on Wednesday, February 26th. Committee members were skeptical of physician and Board of Medical Practice testimony and passed the bill 5-0. The bill has now been sent to the Senate Health & Welfare Committee, which may not have time to take up the bill before crossover.
A bill to license free standing birth centers passed out of the Senate Health & Welfare Committee. VMS and ACOG asked that the bill include support in the form of enhanced Medicaid rates for hospital-based labor and delivery services to make sure they are available when needed. That request was not included in the version of the bill that passed out of committee, although the bill has a number of additional stops and VMS has been in conversation with the Vermont Department of Health about making sure that rules adopted for birth centers address minimum transfer times and having full OB services available at transfer locations.
A summary of many of the bills we are working on is in the document we provide to members who attend legislative breakfasts, here. The breakfasts have been well attended and well received by legislators – there is still time to attend! Consider joining us for one of the remaining breakfasts – learn more here.

Health Care Costs Remain Top of Mind for Regulators, Legislature

As covered above, several legislative committees ended their work before Town Meeting Week with a focus on health care spending, including the Senate Health and Welfare Committee with its health reform bill, which would require the Green Mountain Care Board to establish reference-based pricing based on a multiplier of Medicare for hospitals by 2026 and explore their use for non-hospital services; asks for additional information regarding hospital administrative salaries; requires establishing hospital global budgets by 2028 for five hospitals and all hospitals by 2030; and requires hospitals to submit proposed reductions or eliminations of services made to comply with hospital budget orders; and authorizes the GMCB to investigate the financial operations of any hospital network that derives 50 percent or more of its operating revenue from Vermont hospitals. Meanwhile the House Health Care Committee began walking through a committee bill that would authorize the Green Mountain Care Board to appoint an independent monitor to oversee a hospital and its operations if the Board believes doing so is in the public interest.

The focus on health care costs will likely gain even increased attention on the heels of Blue Cross Blue Sheild of Vermont’s announcement last Monday that the company lost over $60 million in 2024 and will be seeking significant premium increases again for 2026. Last Wednesday, the Green Mountain Care Board hosted the Chief Quality and Clinical Transformation Officer from Cleveland’s University Hospitals, who spoke about how his health care system implemented management strategies to improve their margin and increase the quality of care. Their key strategies included getting paid fairly by making sure they were accurately billing for all services; improving access through making sure patients could get in for urgent appointments and chronic conditions could be managed by primary care and pharmacy; reducing the cost per discharge; and maximizing their ACO performance. State Treasurer Pieciak also held a town hall meeting last Thursday to highlight his proposal to relieve up to $100 million of consumer medical debt and remove medical debt from credit reports. Speakers emphasized the need for the program due to Vermont’s high medical costs and the number of Vermonters who are underinsured so may have insurance but still large out of pocket costs. There are currently bills pending in the House and Senate to move the Treasurer’s proposal forward.

Injunctions Pause Trump Executive Orders Threatening Federal Funding for Transgender Care, DEI Initiatives

According to a press release from the ACLU, last week a federal judge granted a request for a preliminary injunction blocking enforcement of President Donald Trump’s executive orders threatening federal funding for providers of gender-affirming medical care for people under 19. The preliminary injunction extends a temporary restraining order that was previously entered in the case and was set to expire March 5. Read more here.

A separate restraining order prevents enforcement of executive orders threatening to terminate “equity-related” grants and requiring contracting parties and grantees to certify, among other things, that they do not operate DEI programs. Read more here. These are both preliminary injunctions, meaning they maintain the status quo while a legal case is adjudicated, so the ultimate outcome of the executive orders is still undecided.

VMS Members Invited to Climate-Health Lobby Day, 3/12

On Wednesday, March 12th from 9:00 AM - 12:30 PM, The Vermont Climate and Health Association is holding a lobby day at the Statehouse in Montpelier. We know that health professionals are vital to fighting climate-related illnesses. Now, more than ever, we need to show our legislature that our health outcomes are directly related to changing climate conditions. Join us on Wednesday, March 12th to speak with legislators, press, and the public about the work Vermont needs to do to protect our residents from the worst climate health effects.

Tentative Agenda:

9:00 a.m. Meet at Room 10 at the Statehouse for advocacy and issue briefing

10:00 a.m. Committee testimony & individual meetings with legislators

11:00 a.m. Press Briefing in Cedar Creek Room

12:00 p.m. End of press briefing, interested participants continue to meet with legislators and committees

VDH Health Advisory: Ceftriaxone Adverse Events

The Centers for Disease Control and Prevention (CDC) is investigating reports of serious adverse events, including death, following the administration of injectable ceftriaxone (Rocephin) from September 1, 2024 to present.

Requested Actions

Please report adverse events following the administration of ceftriaxone since September 1, 2024, that meet the criteria below to the Health Department’s Infectious Disease Epidemiology program (802-863-7240, option 2; available 24/7):

Occurred within six hours after receipt of injectable (either intramuscular or intravenous routes) ceftriaxone in a non-ICU setting, and
Resulted in death or required cardiopulmonary resuscitation (defined as use of chest compressions and mechanical ventilation or provision of rescue breaths during cardiac arrest), and
Not attributed by the treating provider(s) to a cause other than the ceftriaxone administration (such as known infection, underlying medical condition and/or exposure to medication or medical product other than ceftriaxone).

Continue to use clinical judgement when prescribing ceftriaxone for bacterial infections. Currently there is not a recommendation to hold ceftriaxone.
Review post-injection monitoring protocols and ensure there is a system for prompt reporting of adverse events.
If a serious adverse event does occur, please retain the open vial of ceftriaxone, and await further instructions from the Health Department.
Ensure safe injection practices and other infection control and prevention measures are adhered to when administering medications.
Continue to report serious adverse events associated with medical products to FDA MedWatch.
For full advisory click here (link to VDH alert on website).

For full advisory click here.

Urgent Update: Medicare Physician Payment Relief not Included in Government Funding Package

This past weekend, House leadership in Congress released language for a federal government funding proposal to replace the current "Continuing Resolution" that is set to expire on March 14^th. The proposed package does not contain Medicare physician payment relief, which would lock in a devastating fifth consecutive year of Medicare cuts, threatening access to care for 66 million Medicare patients.

The time is now – please contact Vermont's members of Congress today and urge them to ask leadership to include language from H.R. 879 that would address the Medicare physician payment cut before they vote on the legislation this week.

Since Reps. Greg Murphy, MD (R-NC) and Jimmy Panetta (D-CA), along with a bipartisan group of legislators introduced the "Medicare Patient Access and Practice Stabilization Act" (H.R. 879), over 100 Members of the House of Representatives have cosponsored the bill, and the Congressional Doc Caucus announced its endorsement. This is likely the last, best opportunity to include much-needed payment relief to help stabilize physician practices and ensure access to high-quality care their patients deserve – if the funding package passes without Medicare payment relief, the next opportunity might not be until September. Everyone, including Congress, agrees that the Medicare physician payment model is hopelessly broken, and these yearly cuts are having a negative impact on physician practices while leaving patients’ access to care at risk.

MISC.

Mildred Reardon Medical Student Scholarship Open for Applications

Do you dream of becoming a Vermont doctor?

The Vermont Medical Society’s Education and Research Foundation (VMSERF) is now accepting applications for the Mildred Reardon scholarship, which awards $10,000 to a University of Vermont Larner College of Medicine third year student committed to practicing medicine in Vermont.

The scholarship is made to a student interested in any specialty, with a preference for specialties in high need in Vermont. The scholarship is tuition-linked and is paid directly to the College of Medicine towards tuition. Applications are due April 25, 2025. Click here for more information and details on applying for the scholarship.

Expanding Measles Outbreak in Texas and New Mexico and Guidance for the Upcoming Travel Season

The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to notify clinicians, public health officials, and potential travelers about a measles outbreak in Texas and New Mexico and offer guidance for prevention and monitoring. As of March 7, 2025, Texas and New Mexico have reported 208 confirmed cases associated with this outbreak (198 in Texas and 10 in New Mexico). As a part of this outbreak, two deaths have been reported: one in Texas and one in New Mexico. More cases are expected as this outbreak continues to expand rapidly.

View the full report here.

Compliance Check: 42 CFR Part 2 Updates

Amendments to the federal 42 CFR Part 2 Rule that covers organizations that primarily provide substance use disorder services went into effect on April 16, 2024, with a compliance date of February 16, 2026, when enforcement may formally begin.

To understand the changes and begin to take steps to comply, see useful resources from the Center of Excellence for Protected Health Information (COE PHI), including:

COE PHI recommends that organizations can take the following three key steps to implement the requirements of the 2024 Part 2 Final Rule:

Update consent forms and required notices (they will release a sample updated consent form soon)
Revise agency or organization policies and procedures
Ensure staff knowledge by providing training

Planning for Retirement: March 11th, 5pm EST

VMS has partnered with Planwell to present the Planning for Retirement webinar.

Retirement is often the first thing we think about when we talk about our overall financial well-being. In this seminar, you will learn the basics of retirement planning and what strategies you can use to secure your plan. This presentation covers how to envision your retirement, build your retirement strategy, different sources of retirement income, building your nest egg, and key risks to consider.

View the event flyer here.

Register here.

Salary Data and Contract Review Tips: March 18th, 12-1pm

VMS has partnered with Resolve to help connect members to contract review services and access to compensation data. On March 18th from 12-1pm join Resolve CEO Kyle Claussen for a webinar to learn tips about physician employment contracts. Register here. How do you know what you are worth? What's in a normal contract? How do you know if you have leverage? Kyle will address key contract provisions including:

Compensation
Call Coverage
Maternity Leave
Non-competes
Side Gigs
Intellectual Property
Private Equity Buy-outs

Bring your questions! Whether you are considering your first job after residency, thinking about a position change or just want to understand what is in your current contract, this webinar is for you.

Kyle Claussen is the CEO of Resolve, an attorney and physician compensation and contract expert. He has spent the last decade advocating for physicians in their employment contracts. Kyle is married to an ophthalmologist, has 3 kids, and a dog.

Green Mountain Nursing & Rehabilitation - Physician Search

Green Mountain Nursing & Rehabilitation is looking for a physician and/or physicians to assist in the regulatory physician visits for our sub-acute admissions and long-term care residents whose primary care physicians within the community are not under the UVMMC umbrella.

Green Mountain Nursing & Rehabilitation is located in Fort Ethan Allen in Colchester VT. The commitment is roughly around 16 hrs per week. For more information, please contact Jennifer Combs-Wilber, LNHA at 802-655-1025 ext. 112 or email JCWilber@greenmountainnh.com.

EVENTS

Learning Collaboratives on In-Basket Reduction and Reducing Regulatory Burden

February 2025 – 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.

Navigating Workplace Violence: A Webinar Series on De-escalation Strategies for Healthcare Professionals

March 20, 2025

March 20th, 1:00 PM to 2:00 PM - "Workplace Violence Prevention: Focusing on What’s Most Important"

This session is led by Brendan Riley and is designed to provide professionals with advanced strategies to effectively address workplace risks and foster a safe, supportive environment. This webinar is crafted to address the challenges faced by all healthcare workers, offering insights that can benefit professionals across the entire spectrum of care.

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

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