March 14, 2023

NEED TO KNOW

VMS Policy Resolutions Open for Member Feedback

The VMS Board is seeking member feedback on two policy resolutions related to:

• The Medicare Advantage Program;
• Eliminating Medicare’s Direct Contracting Entity (DCE)/ACO-Reach Programs

All VMS members should have received an email with a link to submit survey feedback on these proposed resolutions between March 14th and April 12, 2023. If you had issues opening up the full resolutions, please try again because the links have since been updated. To read the full resolutions, click here. If you did not receive your survey links or have any questions or concerns with completing the survey please contact bpauley@vtmd.org. The resolutions will then be discussed together with the feedback received from members by the VMS Board at its April 19th Board Meeting.

Resolutions are now considered by the VMS Board on a year-round basis and members can submit resolution topics for consideration at any time. For more information on the resolution adoption process see: https://vtmd.org/vms-resolutions/. Members wishing to listen to the VMS Board discussion or share feedback at the Board meeting can contact bpauley@vtmd.org for zoom log-in information.

The Vermont Legislature is Back and Pushing to Pass Legislation Before Crossover

The VMS Policy Team is back from Town Meeting break and working to cover action across the Statehouse on VMS priority bills before this Friday, which is known as "crossover." Bills need to have passed out of Committees of jurisdiction by the crossover date to advance this session. The money Committees: Appropriations, Ways and Means, and Finance have to finish their work the next Friday on March 24th. Yesterday, the House Health Care Committee presented their FY24 budget recommendations to the House Appropriations Committee in which their highest priority is to increase Medicaid rates in the FY24 RBRVS fee schedule to 110% of Medicare for primary care providers and to give 3.8% inflation increase to specialty care providers. We will be following this closely as it advances. Rebecca Bell, M.D., testified today in the House Judiciary Committee on H.230, a suicide prevention bill, on safe storage for firearms and a 72-hr waiting period. Jessa Barnard, Executive Director of the VMS and Jill Sudhoff-Guerin, policy consultant for VMS, testified on H.222, an opioid overdose prevention bill, on limiting prior authorization for MOUD and ensuring step therapy practices are not used for MOUD. VMS testified on the health impacts of H.270, the medical cannabis program bill in House Human Services and it is scheduled for a vote tomorrow in House Government Operations. Click here for our testimony. 

Please email the House Government Operations Committee and urge them NOT to expand qualifying conditions for the medical cannabis program to conditions lacking evidence, such as autism and Alzheimer’s disease, and NOT to increase the package serving size for commercial products from 50 mg to 100 mg. Click here for email addresses.

Other bills scheduled for a possible vote this week include:

• S.37, the "shield law" protecting clinicians who provide reproductive health care services and gender-affirming care is in S. Appropriations.
• S.36, a bill addressing violence in healthcare settings, is up for a possible vote in Senate Health and Welfare. 
• H.89, the bill to create a forensic facility, is scheduled for a vote tomorrow morning in Senate Judiciary.  

We will be reporting on these bills and more after crossover in the 2023 VMS Mid-Session Legislative Bulletin.

2023 VT Educational Loan Repayment Open For Applications - Up to $50,000 

The 2023 Vermont Educational Loan Repayment (Recruitment/Retention) Program for Physicians, Nurse Practitioners, & Physician Assistants application is now available.

Application and corresponding documents can be found here. This year employer matching funds are encouraged but not required.

The 2023 application deadline is Friday, March 31^st, 2023.

View the full flyer here.

MISC.

AMA Comments on New Education Requirement for DEA Registration Renewals

The AMA submitted comments yesterday to the Drug Enforcement Administration and the Substance Abuse and Mental Health Services Administration regarding implementation of a new 8-hour education requirement for all professionals applying for or renewing their DEA license. In addition to eliminating the X-waiver, the Consolidated Appropriations Act of 2023 also included the Medication Access and Training Expansion (MATE) Act. The MATE Act will require all physicians and other health care professionals who need a Drug Enforcement Administration (DEA) registration as a condition of employment or to prescribe controlled substances in Schedules II, III, IV, or V to complete eight hours of mandatory education on treatment and medication management of patients with opioid and other SUDs unless they qualify for one of the law’s exemptions. The law states that physicians and other health care professionals applying for a new DEA registration or renewing their registration must comply with the one-time eight-hour educational requirement beginning in June 2023. The AMA’s comments reflect their concern that most physicians will not have completed the required education in time, which could result in

potentially dangerous lapses in patient care, and urge a delay in implementation as well as a flexible interpretation of what education would be accepted.

Commissioner of Health Public Health Update on April 6th

The next Public Health Update call with Commissioner of Health Mark Levine, MD will be on Thursday, April 6th 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 view the notes from the March 2, 2023 call here.

You can join the zoom meetings here.

Commissioner of Health Mark Levine, MD, gave a public health update on March 10, 2023 to the Vermont Association of Hospitals and Health Systems. Notes from the call can be found here.

FDA Updates Mammography Regulations to Require Reporting of Breast Density Information

Last week, the U.S. Food and Drug Administration published updates to federal mammography regulations to, among other things, require mammography facilities to notify patients about the density of their breasts, strengthen the FDA’s oversight and enforcement of facilities and help interpreting physicians better categorize and assess mammograms.  The final requirements provide specific language explaining how breast density can influence the accuracy of mammography.  Patients will need to be provided with one of the following two paragraphs, depending on their breast density:  “Breast tissue can be either dense or not dense. Dense tissue makes it harder to find breast cancer on a mammogram and also raises the risk of developing breast cancer. Your breast tissue is dense. In some people with dense tissue, other imaging tests in addition to a mammogram may help find cancers. Talk to your healthcare provider about breast density, risks for breast cancer, and your individual situation.”  Or “Breast tissue can be either dense or not dense. Dense tissue makes it harder to find breast cancer on a mammogram and also raises the risk of developing breast cancer. Your breast tissue is not dense. Talk to your healthcare provider about breast density, risks for breast cancer, and your individual situation.”  All facilities providing mammography services will be required to comply with FDA’s notification requirements, regardless of whether there are applicable State requirements, such as in Vermont. Facilities have 18 months to comply and will need to assess how to incorporate both the state and federal language requirements.  Read the press statement here.

Help Spread the Word about Medicaid Renewals

Vermonters who are currently enrolled in Medicaid, Dr. Dynasaur, and other health benefits will once again see renewal notices in their mailboxes.  The Agency of Human Services is asking for help to build Vermonters’ awareness about renewals restarting, important dates, deadlines, and financial help available through Vermont Health Connect.

What is changing for Vermonters covered by Medicaid programs?

Starting in April 2023, the Department of Vermont Health Access will contact Vermonters when it is time for them to renew. The process of reintroducing renewals will take more than a year with Vermonters receiving outreach at different times. Some Vermonters will not be contacted until as late as April 2024. No one's Medicaid will simply end. Some Vermonters will have their Medicaid renewed automatically. Some will no longer qualify for Medicaid and will have the opportunity to get different health coverage.

Help us spread the word to Vermonters

Please share the materials posted in the Communications Toolkit for the Medicaid Renewal Process widely!

Applications for the Madison-Deane Award for Excellence in End-of-Life Care

Applications are now being accepted through March 17, 2023 for the Madison-Deane Award for Excellence in End-of-Life Care at UVM Health Network Home Health & Hospice

The Madison-Deane Award for Excellence in End-of-Life Care is awarded to a Vermont individual, group or organization that exemplifies the original mission, vision, and continues the legacy of James Madison, MD and Robert Deane, MD and their intent to transform end-of-life care in Vermont.  Nominees must be a Vermont resident, organization, or group doing work in Vermont.  Nominated individuals, groups, or organizations must reflect the original mission, vision, and continue the legacy of Dr. Jim Madison and Dr. Robert Deane.

Excellence is evidenced in the following areas:

1. A catalyst for the acceptance of death as a natural part of life;
2. A leader for education, information and resources relevant to end-of-life issues; and
3. Support for those who create and encourage dialog about how individuals and families face life-threatening illness.
4. Recipient must not have received the Award in the past.

To nominate someone for this award, please submit the nomination form by March 17, 2023.

Feel free to nominate someone and/or share this information.  

Lilly Cuts Insulin Price by 70%, Caps Out-of-Pocket Cost

Eli Lilly will cut prices for most of its insulins in the US by 70% and cap out-of-pocket costs for insulin at $35 per month, the company announced on March 1.

"Lilly is taking these actions to make it easier to access Lilly insulin and help Americans who may have difficulty navigating a complex healthcare system that may keep them from getting affordable insulin," the company said in a statement.

The $35 price cap is effective immediately at participating retail pharmacies for people with commercial insurance. Those without insurance can go to InsulinAffordability.com and download the Lilly Insulin Value Program savings card to receive Lilly insulins for $35 per month.

Read the full article 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.

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 

UVM Medical Center Cardiovascular / Vascular Forum

April 3, 2023

In-person

This course will provide primary care, internal medicine and urgent care providers education about cardiovascular and vascular disease, including additional POCUS skills for evaluation. The objective is to improve accuracy of appropriate and timely cardiovascular disease treatment, and efficiently use expert consultation in a value-based environment.

For more information about our speakers, sessions, accreditation and to register, visit here.

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 

Howard Center Annual Conference: Breaking Barriers: Finding Purpose & Possibilities Together

April 19, 2023

In-person and Virtual

The 6th Annual Howard Center Spring Conference is taking place on April 19th from 8:30am to 4:30pm with featured speakers including Dr. Nadine Burke Harris, Dr. Dacher Keltner, Dr. BJ Miller, Dr. Jeffrey Swanson, and Dr. Anna Malaika Tubbs.

For more information about the speakers, sponsors, and to register, visit here. 

Vermont Geriatrics Conference

April 20, 2023

In-person

The 17th Annual Vermont Geriatrics Conference is designed to equip physicians, advance practice providers, nurses, pharmacists, social workers and other healthcare professionals with practical and innovative approaches to the medical care of older adults.

For more information about our speakers, sessions, accreditation and to register, visit here. 

Diabetes 2023: Updates on Management and Treatment

May 12, 2023

In-person

This conference is designed to equip primary care clinicians and other professionals, including dietitians, with updated knowledge on issues related to outpatient management of patients with diabetes.

For more information about our speakers, sessions, accreditation and to register, visit here.

49th Annual Family Medicine Course

June 6-9, 2023

In-person and Virtual

This intensive four-day program (with optional pre-conference full-day workshop taking place June 5, 2023) for family physicians, advance practice providers, nurses, and other primary care professionals will focus on current issues in the practice of Family Medicine, with special attention to new contributions. Emphasis is on practical, clinically-applicable diagnostic and management issues in primary care.

The conference dates will overlap with the Burlington Discover Jazz Festival, and all ages, live-music event on four stages in downtown Burlington that brings the community to life! 

The pre-conference workshop titled Mastering Early Goals of Care Conversations will take place on June 5, 2023

Empathic, honest conversations are cornerstones of patient- and family-centered care. Research shows that patients who speak with their clinicians about their goals and values are more likely to receive the care they want, have fewer non-beneficial medical treatments, spend fewer days in hospitals and intensive care units, and report a better quality of life. Take part in this safe, small group pre-conference workshop.

For more information about our speakers, sessions, accreditation and to register, visit here.

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

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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