March 26, 2024

NEED TO KNOW

Please Take Action: Governor Now Decides Fate of Bill to End Sales of Flavored Tobacco 

S.18, the bill to end the sale of flavored tobacco products in Vermont, passed the Legislature last week and now awaits being sent to the Governor. Once it is sent to his desk he has 5 days, excepting Sunday, to sign it, allow it to go into law or to veto the bill. He has made statements suggesting he may veto the bill – your contacts are critical (see press coverage here and here). Now is the time to call upon the Governor to put the health of youth over profit and prevent the next generation of Vermonters addicted to nicotine. What to do:

  • Call the Governor today at 802-828-3345 and remind him that flavored tobacco products are hurting Vermont youth and families and ask him to allow S.18 to become law.
  • Take a look at how your Representatives and Senators voted and reach out to thank those that supported this important measure.

Additional talking points:

  • During the last 30 days, 16% of Vermont high schoolers have used an e-cigarette product. Of those who vaped, 30% used it every day - indicating addiction;
  • Teens who first try tobacco using a vape are four times more likely to try cigarettes;
  • 95% of adults start smoking before 21 years old.

One more step! Don’t delay in your outreach!!!

House Budget Deliberation to Dominate Discussions in Statehouse

The House Appropriations Committee has passed their version of the FY25 Budget by a vote of 8-4-0 and advances to the House floor this week. The Committee-passed version does not include a lot of additional funding for health care priorities but contains several required reports on proposed policies to improve health care access and reimbursement. Here are some of the reports and appropriations included in the proposed budget: 

  • Proposed Methodology for RBRVS fee schedule: By December 15th, the Department of Vermont Health Access must meet with stakeholders and report back to the legislature on a Medicaid RBRVS fee schedule methodology for 2025 that considers a floor to the “conversion factor” used so that the Medicaid fee schedule does not decrease if the Medicare fee schedule decreases.   
  • Psychiatric Residential Treatment Facility funding included forthe creation of 15 beds at the Brattleboro Retreat.
  • AHS required to report on the potential for creating 41 youth mental health beds: for inpatient, psychiatric residential, stabilization, and treatment services, including projected reductions in out-of-state placements.
  • Prevention Coalitions and Student Assistance Professionals: funding from Vermont's Opioid Abatement Fund is directed to prevention coalitions and to expand student assistance professionals.

The full House will deliberate on the budget on Thursday of this week. Here are some other actions scheduled this week.

Resources to Assist With Change Healthcare Cyber Security Incident

VMS is collating resources to assist practices with the Change Healthcare cyber security response at https://vtmd.org/resources-to-assist-with-change-healthcare-cyber-security-incident.   Practices should review the list of Change Healthcare products and applications that were impacted by the February 21 cyberattack at Optum Solutions Status and determine if your practice is experiencing any previously unknown claims submission or payment issues with Change Healthcare affiliated products.  You can also contact your payer representatives to make sure claims are being received and processed as expected.  Please reach out to Jessa Barnard at jbarnard@vtmd.org to inform VMS of ongoing concerns or resources needed to address the incident.  VMS is in touch with payers and the Department of Financial Regulation and wants to hear from you so we can express unmet practice needs.    

Supreme Court Hears Mifepristone Case

The Supreme Court heard oral arguments this morning in the case regarding the FDA’s approval of the abortion medication mifepristone, Food and Drug Administration et al. v. Alliance for Hippocratic Medicine et al.  According to coverage by SCOTUS Blog, there were three questions before the Court today: (1) whether the challengers have a legal right to sue, known as standing; (2) whether the 5th Circuit was correct when it rolled back the FDA’s 2016 and 2021 changes to the conditions of use for mifepristone; and (3) whether the relief that the 5th Circuit ordered was appropriate in its decision to roll back the changes based on its finding of flaws in the FDA’s decision-making.  In the hearing this morning a number of Justices raised concerns about whether the doctors who brought the lawsuit had demonstrated enough harm from the FDA’s actions to allow them standing to bring suit.  Recordings of the oral argument can be found from the AP here (advance to hour 2:50:26).   A transcript of oral argument will be available here.  The American Medical Association has joined 15 leading medical societies representing hundreds of thousands of physicians and other clinicians nationwide in an amicus brief telling the court about the safety and efficacy inherent within FDA’s approval of mifepristone, and how access to mifepristone is essential in caring for patients. More broadly, the AMA has also expressed concern about this type of judicial activism against FDA-approved drugs that would undermine access to other lifesaving treatments. 

MISC.

Match Day 2024: Emergency Medicine Recovers, Pediatrics Sees Decline


According to Medscape, as US medical school graduates learned Friday, March 15, where they would spend their residencies, new Match Day 2024 data showed a loss of interest in pediatrics, whereas emergency medicine regained popularity after concern over last year's unfilled positions.


Hospitals and medical groups offered 41,503 residency positions in 2024, a 3% increase from last year, according to the data released by the National Resident Matching Program. 


Emergency medicine reversed its recent decline, with only 135 unfilled positions, a 13.9% improvement over last year. 


But though the number of pediatric residency slots increased slightly from last year, 8% of available positions remained unfilled in 2024 compared with about 3% last year.  Read the full Medscape article here.   


For coverage of the placement of UVM Larner College of Medicine students, click here. Out of the 117 medical students participating, a noteworthy 46 were matched into primary care residencies, including internal medicine, family medicine, and pediatrics. 

Clinical Reminder: Over The Counter Progestin-Only Birth Control Pill Coming on the Market

The first over the counter progestin only birth control pill, "Opill," made by Perrigo is coming on the market in the next few weeks. Please be aware that patients may begin using it and it should be added to medication lists if patients report using it.

Progestin only pills have all active hormone pills, no placebo week, so there is no regular withdrawal bleed as there is with combined hormonal contraceptive pills that have placebo pills. Breakthrough bleeding can be more common with progestin only pills.

It is important that progestin only pills be taken at the same time every day due to their pharmacology.

As with Levonorgestrel emergency contraception pills, there is no lower age limit for people to buy Opill.

See below for tip sheets and FAQs

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.– Note: the start of these sessions have been moved a week later

InvestWell: Understanding How to Put Savings to Work - March 26th
Gain a clearer picture of how to grow a nest egg by investing it.

LiveWell: Protecting a Fulfulled Life and Retirement - April 2nd
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

Commissioner Call Held March 7th; Next Call is April 4, 2024

The Commissioner of Health, Mark Levine, MD, held his most recent VMS member call on March 7th.  Notes from the call are here. Commissioner Levine highlighted recent changes in COVID isolation policy as well as new booster recommendations for adults over 65.

He will hold his next Public Health Update with VMS Members on Thursday, April 4th at 12:30 pm. You can join the zoom meetings here.

VMS Board Seeking Resolution Feedback by March 27th

The VMS Board is seeking member feedback on a policy resolution related to:

  • Support for Expanded Coverage for Obesity Treatment

The full text of the Resolution is available here.

You should have received a survey link specific to you on Wednesday, February 28th. If you did not receive your survey link or have any questions or concerns with completing the survey, please contact bpauley@vtmd.org.

The survey will be open for member comment between February 28, 2024 and March 27, 2024. The resolutions will be discussed together with the feedback received from members by the VMS Board at its April 10th Board Meeting. If you would like to join this meeting via Zoom, please contact Birdie Pauley at BPauley@vtmd.org.

Survey: Integrating Gender-Affirming Care into Primary Care

Throughout Vermont, transgender and gender-diverse people look to primary care providers for inclusive, respectful, affirming healthcare. We’d like to learn more about the care that PCPs currently provide for transgender patients, barriers that they encounter, and what resources they would find helpful to meet these patients’ needs.

We would like to hear from all physicians, NPs, and PAs providing primary care for adults and/or youth in Vermont. If you currently see few or no transgender patients, we are especially interested in hearing from you!

Please click here to take the survey: https://redcap.link/vttranshealth

The survey is open until Friday, March 29, and takes about 10 minutes to complete. Respondents will be entered into a raffle for one of twenty $20 Amazon gift cards.

This project is based at The Fenway Institute and is led by Eli Goldberg, MD, a family physician raised and trained in Vermont who is currently doing a fellowship in LGBTQIA+ Health. Questions? Please email Eli Goldberg: egoldberg@fenwayhealth.org

 

EVENTS

2024 Vascular and Cardiac Forum

April 1, 2024

In-Person South Burlington, VT

The vascular and cardiac forum this year will provide primary care, internal medicine, urgent care, and physical therapy providers with education about a variety of vascular and cardiac conditions. The objectives are to improve accuracy and timeliness of the diagnosis and treatment of these conditions, and efficiently use expert consultation in a value-based environment.

Registration Information, full agenda and accreditation details can be found here.

18th Annual Vermont Geriatrics Conference

April 16, 2024

In-Person South Burlington, VT

Please join us for the 18th Annual Vermont Geriatrics Conference. The conference is designed to equip nurses, nurse practitioners, pharmacists, physicians, physician assistants, social workers and other healthcare professionals with practical and innovative approaches to the medical care of older adults.

Registration Information, full agenda and accreditation details can be found here.

Diabetes 2024: Updates on Management and Treatment

May 3, 2024

In-Person South Burlington, VT

This conference is designed to equip primary care clinicians with updated knowledge on issues related to outpatient management of patients with diabetes. Specific topics to be addressed at this year’s conference include Lipid-Lowering Therapies to Reduce Cardiovascular Disease, Basal Insulin Use, Insulin Titration, MASLD (Liver Disease) and more.

Registration Information, full agenda and accreditation details can be found here.

The 50th Annual Family Medicine Course

June 4th-June 7th, 2024

In-Person South Burlington, VT

This intensive four-day program 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. An optional, pre-conference full-day workshop on Mastering Early Goals of Care Conversations will also be offered. Conference emphasis is on practical, clinically applicable diagnostic and management issues in primary care. This conference will be presented in-person and virtually; participants may choose to join via a mixture of in-person and remote attendance. This conference is also anticipated to overlap with the Burlington Jazz Festival, taking place June 5-9, 2024.

Registration Information, full agenda and accreditation details can be found here.

Whole Person Care: Enhancing Substance Use Disorder and Mental Health Treatment

June 14, 2024

Lake Morey, VT

Please mark your calendars for Friday June 14 when we will be hosting "Whole Person Care: Enhancing Substance Use Disorder and Mental Health Treatment", an in-person conference at Lake Morey, VT.

This is a part of the Collaborative to Advance Mental Health Treatment and Substance Use Recovery for Everyone (or CARE Series).

Learn more 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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