April 12th, 2022

NEED TO KNOW

Alert - Scam Targeting Vermont Physicians

The Vermont Medical Society was made aware last week of a scam targeting doctors in Vermont, across geographic locations in the state. The physicians targeted have been called, including on the physician’s private cell phone number after hours, by individuals representing themselves to be deputy sheriffs from the local sheriff’s department. The individuals inform the doctor that he or she has a warrant out for their arrest for failure to appear at court pursuant to a subpoena that they accepted service on, and that the doctor can either 1) be arrested criminally for failure to appear or 2) to handle this matter “civilly” by paying a “bond” and therefore avoid their arrest. The scammers use extensive personal information to make it seem plausible that they are law enforcement, including knowledge of a physician’s legal history and mirroring names and cell phone numbers of county sheriff staff.

What to do if you are targeted by this scam: Do not provide any personal or financial information to the caller. Immediately end the call. Call the direct landline of the county sheriff’s department - as opposed to any number given to you by the caller - to confirm the validity of the call and report the scam: https://www.vtsheriffs.com/sheriff-department-duties-and-services.php. Report the scam to the Consumer Assistance Program of the Attorney General’s Office: https://ago.vermont.gov/cap/stopping-scams/. Reach out to your practice attorney for further guidance.

Legislature Working to Determine Priorities as They Push Toward Adjournment

As we head into the 14th week of the 2022 legislative session, Senate lawmakers are grappling with how to complete their work on the approximately $8 billion of funding included in H.740, the FY23 budget bill; how to prioritize workforce initiatives in H.703, the workforce development bill; and how to pacify the Governor's unmet recommendations for investment in broader economic development. Senate Committees will be ceasing their morning work, as the Senate Appropriations Committee is expected to finish their work on the budget package this Friday. All focus will then move to House and Senate floor debates and conference committees. There are still a lot of loose ends for the VMS budget/workforce priorities, and please see our continued action alert on the primary care loan repayment program. VMS also supports restoring the Governor's recommendation to invest $3.5 million in the 12 prevention coalitions that provide youth prevention services and education across the State. This week, Jessa Barnard will testify in the House Health Care Committee on S.285, the health reform bill that includes further developing hospital value-based payments and an examination of expanded payments to the Blueprint for Health. Jessa will also testify in the House Human Services Committee on S.90, a bill to create an ALS registry. Jill Sudhoff-Guerin will testify in the Senate Judiciary Committee on H.548, the miscellaneous cannabis bill.

Action: Lawmakers are Considering Expanding Vermont’s Loan Repayment Program And Need to Hear From Clinicians Now!

Thanks to your advocacy over the last week, the Senate Health & Welfare and Senate Economic Development Committees are considering increasing AHEC loan repayment funding in their health care workforce initiatives (H. 703 and the FY23 Budget). Between now and early next week is the time to tell them to restore the AHEC primary care loan repayment program to 2009 funding levels, by investing an additional $793,000. This is a small investment with a big benefit to help Vermonters access health care, especially in light of H.703 containing $105.7 million for workforce development and over $65 million for health care workforce initiatives but ZERO for primary care recruitment/retention.

Instead of increasing support, over time, the funding for Vermont AHEC's Educational Loan Repayment Program has been drastically reduced to a current rate of $667,111 from a high in FY2009, when it was provided $1,460,000. The key Senate Committees are interested in supporting the VMS ask, but they need to hear from our members why they should fund loan repayment over countless other asks.

Thank you to all VMS members who have reached out already! We urge all of you to use your voice to impact the future primary care workforce in Vermont. Please tell the Senate Health and Welfare and the Senate Economic Development Committees how increasing funding for AHEC's loan repayment is critically necessary for primary care workforce recruitment, both in your practice and statewide. Click here for the VMS Loan Repayment Memo.

Please email these Senators:

vlyons@leg.state.vt.us; chooker@leg.state.vt.us; jterenzini@leg.state.vt.us; acummings@leg.state.vt.us; rhardy@leg.state.vt.us; bbalint@leg.state.vt.us; msirotkin@leg.state.vt.us; kramhinsdale@leg.state.vt.us; aclarkson@leg.state.vt.us; rbrock@leg.state.vt.us; SMoore@leg.state.vt.us

Press Conference Update on COVID-19 Cases, Opioid Overdose

At today’s Administration press conference, Commissioner of Health Mark Levine, MD, emphasized that the BA.2 variant is leading to an expected slight increase in COVID-19 cases.  The 7-day average has increased from 152 to 196 (+29%) cases per day over the last week.  While hospitalization and ICU admissions have also slightly increased, they are not approaching anything like Omicron levels and the administration is not recommending any additional mitigation measures at this point.  Commissioner Levine emphasized that BA.2 has been in Vermont for a number of weeks now – it is unclear how long it will continue to predominate.  The Commissioner also discussed the recent report showing Vermont had the highest number of fatal opioid-related deaths in 2021, a 33% increase from 158 deaths in 2020 to 210 in 2021.  Notes from the press conference can be found hereThe DFR Modeling report for the week can be found hereTo view the call notes with Mark Levine, Commissioner of Health from April 7th, please click hereTo view the VAHHS call notes with Mark Levine, Commissioner of Health from April 8th, please click here

New No Surprises Act Resources Available from AMA, CMS

Linked here is a second AMA toolkit to assist physicians with the payment process for certain out-of-network care under the No Surprises Act (NSA).  All of the AMA’s implementation resources, including updated information on the AMA-AHA lawsuit over a narrow, but critical, component of the interim final rule implementing the IDR process under the NSA, can be found here.    CMS has also released updated FAQs regarding implementation of Good Faith Estimates (GFE) for uninsured or self-pay patients that address questions such as what to do if the provider or facility does not know the patient’s diagnosis at the time of scheduling or if the patient’s insurance status changes.   Also, as a reminder to members – health plans must now verify provider directory listings every 90 days.  If you do not reply to such requests, you can be removed from the provider directory or even the insurance panel.  Make sure you are keeping your contact information up to date with all insurers and replying to requests for provider directory information.

MISC.

Mobile Crisis Services Survey

Vermont has a federal grant to support the expansion of community-based mobile crisis intervention services. This funding provides an opportunity to build on Vermont’s mobile crisis system of care. The Agency of Human Services (AHS) wants to hear your thoughts and experiences about mobile crisis services. Your input is vital in helping Vermont improve services. On behalf of AHS, Health Management Associates (HMA) is conducting this survey. The survey will take about 15 minutes to complete. The mobile crisis survey can be found here. For more information about the project, please visit the AHS mobile crisis planning grant website and view the recording of the Virtual Town Hall. Please contact Raisa Alam of Health Management Associates (HMA) if you need help with the survey: ralam@healthmanagement.com. All individual survey responses will be kept confidential. The state will not identify individuals or organizations and no personal information will be shared. The survey will close Friday, April 29, 2022.

Reminder: Provider Relief Fund Requests for Late Reporting Due by April 22/HRSA Identifies Extenuating Circumstances

In response to AMA and specialty society advocacy, the Health Resources and Services Administration (HRSA) has decided to reopen the reporting time for recipients of Period 1 Provider Relief Funds. Physicians who received more than $10,000 in provider relief funds and failed to submit their Period 1 report should act immediately. Between Monday, April 11 and Friday, April 22, 2022, at 11:59 pm ET, providers who have not submitted their Period 1 report may submit a late Reporting Period 1 report request. Physician practices should receive information about how to submit a request directly from HRSA via email. If a provider did not submit a Period 1 report and does not hear from HRSA, the provider may initiate communication by calling (866) 569-3522.

During this reopening period, a provider must choose an extenuating circumstance(s) that prevented compliance with the original reporting deadline. HRSA has just released the following as allowable extenuating circumstances:

  • Severe illness or death – a severe medical condition or death of a provider or key staff member responsible for reporting hindered the organization’s ability to complete the report during the Reporting Period.
  • Impacted by natural disaster – a natural disaster occurred during or in close proximity of the end of the Reporting Period damaging the organization’s records or information technology.
  • Lack of receipt of reporting communications – an incorrect email or mailing address on file with HRSA prevented the organization from receiving instructions prior to the Reporting Period deadline.
  • Failure to click “submit” – the organization registered and prepared a report in the PRF Reporting Portal, but failed to take the final step to click “submit” prior to deadline.
  • Internal miscommunication or error – Internal miscommunication or error regarding the individual who was authorized and expected to submit the report on behalf of the organization and/or the registered point of contact in the PRF Reporting Portal.
  • Incomplete Targeted Distribution payments – the organization’s parent entity completed all General Distribution payments, but a Targeted Distribution(s) was not reported on by the subsidiary.

While attesting to an extenuating circumstance is required, no supporting document or proof is required. If HRSA approves the extenuated circumstances form, the provider will receive a notification to proceed with completing the Reporting Period 1 report shortly thereafter. Providers will have 10 days from the notification receipt date to submit the late Period 1 report in the PRF Reporting Portal. More information is available here. The AMA will continue to advocate for greater flexibility and more information to ensure physician practices have an adequate opportunity to come into compliance.

Vermont Medicaid Timely Filing Reconsideration Request Update

Effective for requests received on or after 04/01/2022, the Agency of Human Services (AHS)/Vermont Medicaid will no longer offer a second opportunity for providers to submit additional information to support a request that the Agency reconsider denying a claim for failing to timely file. If providers do not include the required documentation with their request for reconsideration, the Agency will deny the request, and no further recourse will be available with the Agency. As a reminder, when requesting reconsideration, providers are required to include a detailed description of the circumstances resulting in their failure to timely file the claim and supporting documentation as described in Section 3.3.2 of the Vermont Medicaid General Billing and Forms Manual. Acceptable forms of supporting documentation include billing account notes, call reference numbers, other insurance correspondence and/or emails with the Agency or fiscal agent.

CMS Finalizes Medicare Coverage Policy for Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer’s Disease

Last week, the Centers for Medicare & Medicaid Services (CMS) released a national policy for coverage of aducanumab (brand name Aduhelm™) and any future monoclonal antibodies directed against amyloid approved by the FDA with an indication for use in treating Alzheimer’s disease.  For drugs that FDA has not determined to have shown a clinical benefit (or that receive an accelerated FDA approval), Medicare will cover in the case of FDA or National Institutes of Health (NIH) approved trials.  Monoclonal antibodies directed against amyloid that are approved by FDA for the treatment of AD based upon evidence of efficacy from a direct measure of clinical benefit may be covered in CMS-approved prospective comparative studies.  For more information see the fact sheet and Q&A here.  

VPQHC Update on Telehealth Billing from Vermont Payers

Last week, Vermont Program for Quality in Health Care hosted a virtual discussion with Blue Cross and Blue Shield of Vermont, MVP Health Care, and Vermont Medicaid, to hear about their latest telehealth policies, including details on billing, coding, and reimbursement. Each payer provided a brief overview of their current telehealth policies, and a Q&A session followed.  The recording and slides can be found here.

EVENTS

Join us every 1st and 3rd Thursday of the month from 12:30pm to 1pm as Commissioner of Health, Mark Levine provides us with the most pressing COVID-19 information affecting the state and nation. You will have the opportunity to submit questions to Dr. Levine who will answer them, time-permitting.

You can join the zoom meetings beginning in January here or add to your calendar by following this link and clicking download (you will then need to open the downloaded file and click save to add to your calendar).

No Cost Well-Being Workshops

VMS is continuing our partnership with Doug Wysockey-Johnson of LumunosWellBeing to offer no-cost clinician wellbeing workshops at up to 10 Vermont medical staffs/practices over 2022. There are 3 remaining slots available this spring.  New topics for 2022 include A Clinician’s Guide to Recovering from the COVID Marathon and A Realistic Look at ‘Work-Home Balance’ for Clinicians. See the full list and additional details here.  Members can contact jbarnard@vtmd.org or doug@lumunos.org for more information or to schedule a workshop. 

Clinician Information Sessions: New 2022 DNR/COLST Form

April 14, April 26, May 11, May 26, 2022, 12pm to 1:15pm

Virtual


On June 1, 2022, the Vermont Department of Health will be launching a new and improved DNR/COLST form for use across the state. Join the Vermont Ethics Network's Executive Director & Clinical Ethicist, Cindy Bruzzese, MPA, MSB, HEC-C, to learn about the new Vermont DNR/COLST form and review best practices for completing medical orders.

Registration here.

3rd Annual Teaching Cannabis Awareness and Prevention 2022 

April 27 - 28, 2022, 8am to 12:45pm (PST)

Virtual

The 3rd Annual Teaching Cannabis Awareness & Prevention Conference: A Focus on the Triangulum of Cannabis, Tobacco, and Vaping is a 2 day virtual conference will be held on April 27th, 2022 & April 28th, 2022 from 8am-12:30pm PST. Registration for this conference is $125. To view the conference schedule and speakers at a glance, please click here.

Registration information can be found here.

The UVM Medical Center Cardiovascular/Vascular Forum

May 2, 2022

In-Person and Virtual Option

Course Director Dr. Matt Alef invites Primary Care, internal medicine, and urgent care providers to attend virtually or in-person at the Delta-Marriott, South Burlington, VT to learn more 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.

TOPICS include: SAVR vs TAVR, vascular nurse wounds, aortic dissections, POCUS hands-on workshop, echocardiography and more.

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

The Upstanders, An Indieflix Film About Cyberbullying

May 4, 2022, 6pm to 7:30pm

The Upstanders explores all sides of cyberbullying, from bully to victim, bystanders, and family members. Social media’s power means that bullying is now a 24/7 phenomenon, where even changing schools and phone numbers, or deleting accounts cannot stop the cycle. COVID has increased the incidence of cyberbullying by 70%. Changing human behavior and connection is the key, and this is what the film addresses.

Weaving together personal stories of teenagers and their families, as well as teachers and brain-scientists, The Upstanders shows the importance of empathy and resilience to transforming attitudes and action, and highlights new laws and established programs that are already reducing bullying in schools and communities. It shows that everyone is needed to eradicate cyberbullying, and gives bystanders the confidence and tools to become ‘Upstanders’, and help change the narrative. To view the trailer, please visit their website.

This film screening and panel discussion is hosted in partnership with Champlain Community Services. This event is part of The Marna and Stephen Wise Tulin Spring Community Education Series presented by the Howard Center. Read more about the series here.

Register here.

How Can We Make Vermont More Welcoming and Inclusive for Our Diverse Community?

May 18, 2022, 6pm to 7:30pm

Vermont is one of the least diverse states in the nation. With that as our starting point, how can Vermont attract more people with diverse backgrounds and help them find community so they decide to stay? Join a panel of professionals working to promote diversity and equity in area businesses and institutions to hear about lessons they’ve learned in the workplace, and how those lessons can be applied to make the Green Mountain State more welcoming and inclusive.

This event is part of The Marna and Stephen Wise Tulin Spring Community Education Series presented by the Howard Center. Read more about the series here.

Register here.

The 48th Annual Family Medicine Review Course

June 7-10, 2022

In-Person and Virtual

Course Director Dr. Anya Koutras invites you to this intensive four-day program for family physicians and other primary care professionals. The program will focus on current issues in the practice of Family Medicine, with special attention to new contributions. Attendees will have a choice between in-person at the DoubleTree by Hilton Hotel, Burlington, VT and virtual participation. This conference coincides with the Discover Jazz Festival and makes it a great time to bring the family for a visit to Burlington. TOPICS include: genomics testing, Parkinson’s disease, hypothyroidism, headache management, valvular heart disease, type-2 diabetes, HPV disease, bipolar disease, endometrial cancer, LARC, skin biopsies, end of life care, knee exam, substance use disorder, gender-affirming care, geriatric psychiatry, urgent care cases

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

Vermont Medical Society Annual and Collaborative Meeting

November 4th and 5th, 2022

The 209th VMS Annual Meeting will be held on November 4th and 5th in person at Topnotch Resort, Stowe, VT, with virtual options. The weekend will be filled with educational content, time to spend with colleagues, policy-setting meetings, and the opportunity to honor physicians and other health care leaders across the state. VMS’ Annual Meeting, hosted in collaboration with the American Academy of Pediatrics Vermont Chapter, the Vermont Academy of Family Physicians and the Vermont Psychiatric Association, is a celebration of the unwavering commitment Vermont clinicians have to their practice and to the deep connection VMS members have with each other.

To view more information or submit nominees for 2022 leadership awards, please click here. Registration information will be shared in the future.

UVM will have more primary care conferences in Fall 2022. Sign-up to get updates via email for topics that are of interest here.

VTMD.ORG

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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