April 11, 2023

NEED TO KNOW

Reproductive Access Takes Center Stage this Week

While access to abortion medication is under debate in federal District courts, the Vermont Medical Society is working with the Vermont Attorney General’s office and legislative leaders to determine if Vermont can do more to protect access to mifepristone. Click here to read the VMS press release "Vermont Health Leaders Denounce Court Decision that Could Restrict Access to Medication Abortion." 

The Legislature also continues to work on the "Shield laws" that aim to provide protection for clinicians who provide abortion services and gender-affirming care.  The House Health Care Committee is dedicating a second week to testimony on S.37 and will hear from Jessa Barnard and the Senate Judiciary Committee will hear from Vermont Medical Society member Erica Gibson, M.D., on H.89. 

Other public health measure continue to move through the legislature.  Please take action: the Senate Judiciary Committee is considering H.230, the suicide prevention bill that contains firearm regulations, and will hear from Rebecca Bell, MD, on Wednesday morning. Please urge the Committee to support this bill, which contains a safe storage requirement for firearms and a 72-hr waiting period to purchase a handgun. Click here for the emails.

Please urge the House Human Services Committee to take up and pass this session the flavored tobacco product ban bill, S.18. We cannot wait to help prevent Vermont youth from starting a dangerous nicotine habit by prohibiting flavored tobacco products, including menthol cigarettes. These products are easier to smoke, harder to quit and more likely to addict youth. Click here for the Committee email addresses.

VMS Resolution Survey Closing, Board Meeting Discussion April 19th

The VMS Board has been circulating a survey to receive member feedback on two proposed policy resolutions related to:

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

The survey is closing this Wednesday, April 12, 2023. 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 be discussed together with the feedback received from members by the VMS Board at its April 19th Board Meeting.   The meeting is being held from 5-7pm remotely via zoom. Members wishing to listen to the VMS Board discussion or share feedback at the Board meeting can contact bpauley@vtmd.org for log-in information. Other topics on the agenda for the Board meeting include a legislative update and voting to remove members who have not paid 2023 dues.   

VMS Members Advocate at Climate and Health Legislative Day

Pictured above, VMS Board Member Jessie Leyse, MD, along with VMS Members Megan Malgeri, MD and Sue Deppe, MD took to the podium last Thursday to urge the Vermont legislature to take action to address the causes of climate change.  They shared their experiences witnessing the impacts of the changing environment on their patients, such as increased cases of tick-borne illness and mental health stressors caused by climate disasters.  VMS co-hosted the event, along with the Vermont Public Health Association and Vermont Climate and Health Alliance.

Prior Authorization Reforms in the Medicare Advantage Part C and D rule

Last week, the Centers for Medicare & Medicaid Services (CMS) released a final rule on Medicare Parts C and D that addresses a number of changes to the programs.  Among those are changes to the prior authorization process under Medicare Advantage (MA).  It appears that many of the provisions that state medical societies and the AMA advocated in support of in February (and for years before that) have been finalized.  In terms of prior authorization, it appears that CMS has taken steps to ensure greater continuity of care, improve the clinical validity of coverage criteria, increase transparency of plans’ prior authorization processes, and reduce care disruptions due to prior authorization requirements. These changes will take effect on January 1, 2024. CMS has indicated that other proposed reforms such as gold carding and implementation of the real time prescription benefit standard will be addressed in a later rule.  We have all long advocated for meaningful prior authorization reforms and it appears these changes, overall, will be important steps in reducing the burden and harms associated with MA prior authorization requirements. 

MISC.

STI Awareness Week

STI Awareness Week provides an opportunity to raise awareness about sexually transmitted infections, or STIs, and how they impact our lives; reduce STI-related stigma, fear, and discrimination; and ensure people have the tools and knowledge for prevention, testing, and treatment.

Learn more here.

Long-sought Medicare Payment Proposal Introduced

Last week, Reps. Raul Ruiz, MD (D-CA), Larry Bucshon, MD (R-IN), Ami Bera, MD (D-CA) and Mariannette Miller-Meeks, MD (R-IA), introduced legislation in Congress to apply an automatic inflation update to Medicare physician payments. The bill, H.R. 2474, would tie the Medicare physician fee schedule to the Medicare Economic Index (MEI), something the AMA and VMS have long supported. Doing so would put physicians on equal footing with almost all other health care providers that receive annual inflation-based updates. Current law requires physician payment rates to be frozen from 2020 through 2025, and most services will receive a minimal 0.25% annual update in 2026 and onward. See more from the AMA here.

AHRQ Safety Program for Telemedicine, Improving the Cancer Diagnostic Process – Deadline May 25^th

Is your practice interested in improving the cancer diagnostic process for your patients who receive some or all of their care via telemedicine? The Agency for Healthcare Research and Quality (AHRQ)  is recruiting ambulatory and primary care facilities, including OB/GYN practices for a free 18-month program to improve diagnostic verification, timeliness, and communication with patients diagnosed with breast, colorectal, and lung cancer.  Practices will receive training and one-on-one expert coaching to implement sustainable improvements to effectively close the loop at critical points in the cancer diagnostic process. The application deadline is May 25, 2023 and the program will begin in June. Learn more here. 

Reminder: 8-hour Training Requirement for All DEA-Registrants – Effective June 2023

As covered in the Rounds last week, the US Drug Enforcement Administration (DEA) has issued a letter outlining a new one-time, eight-hour training requirement for all DEA-registered practitioners on the treatment and management of patients with opioid or other substance use disorders. This training was passed as part of the Consolidated Appropriations Act of 2023 and will go into effect June 27, 2023.  Find the full letter outlining ways to meet the training requirement here: https://deadiversion.usdoj.gov/pubs/docs/MATE_Training_Letter_Final.pdf

MIPS EUC Hardship Exception Due to COVID-19 Continues in 2023

In response to advocacy from the American Medical Association and organized medicine about the ongoing impacts of the COVID-19 public health emergency (PHE), the Centers for Medicare & Medicaid Services (CMS) will continue to allow physicians and group practices to apply for a MIPS Extreme and Uncontrollable Circumstances hardship exception to avoid up to a -9% MIPS penalty in 2025 based on 2023 performance. The exception will not be automatic, and interested physicians and groups must actively request reweighting of one or more MIPS performance categories due to the COVID-19 PHE. Requesting reweighting of all four MIPS performance categories will avoid a MIPS penalty in 2025. CMS expects to release the hardship exception application in spring 2023.

This is a big relief for physicians and their patients because CMS estimated in the final rule that up to one-third of MIPS eligible clinicians would have received a penalty due to the increasingly stringent requirements to participate in MIPS in 2023. It is also likely that small, rural, and practices serving underserved populations would have been disproportionately impacted by these penalties.

Baystate Financials' Plan Well Financial Education for Physicians

Vermont Medical Society has partnered with Baystate Financial for The PlanWell™ Series. This is a financial education curriculum geared explicitly towards VMS members. The objective is to help you realize your financial goals, whether it's saving for a house, paying off student debt, or planning for retirement.

There will be multiple webinar offerings in May for early to mid-career physicians and PAs (click here for details) and for late-career to retired physicians and PAs (click here for details).

Learn more and register here.

Commissioner of Health Public Health Update on May 4th

The next Public Health Update call with Commissioner of Health Mark Levine, MD will be on Thursday, May 4th 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 April 6, 2023 call here.

You can join the zoom meetings here.

EVENTS

Vermont Ethics Network Presents: Spring 2023 Palliative Care Virtual Series

April 18th, 25th, May 4th, 9th, 17th from 12pm to 1:15pm

Virtual

Join the Vermont Ethics Network for their first session in their Spring 2023 Palliative Care Virtual Series!

Tuesday, April 18th: They Just Don't Get It: Serious illness communication strategies, skills, opportunities and pitfalls will be presented by Diana Barnard, MD - Associate Professor of Family Medicine & Lead Palliative Care Physician - UVM Health Network - Porter Medical Center. Register here.

Other sessions include:

• April 25th - Mining the Language Gap: The words we use may not always convey the meaning we intend
• May 4th - Uncertain End of Life Trajectory: Care implications for patients with severe psychiatric illness
• May 9th - Clear as Mud: The nuances of hospice eligibility & financial issues at end of life
• May 17th - Use of Opioids in Serious Illness: Inpatient and outpatient considerations

Learn more about all sessions here.

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. 

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

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

View the topics of the webinar series here.

Integrative Pain Management Conference

May 5, 2023

In-person

This conference will meet the needs of an interdisciplinary healthcare community in the following ways:

1. Learn about integrative therapies and share best practices, research, and innovations in integrative approaches for chronic pain management.
2. Understand national initiatives and innovative policies that increase access to high-quality, evidence-based, comprehensive pain 

Learn more and register 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.

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

-- Unsubscribe --