April 26th, 2022


Governor Focuses Weekly Press Conference on Workforce Development

Governor Phil Scott and Administration officials held their weekly press conference at ‘Vermont’s Largest Job Fair’ held today at the Champlain Valley Expo.   Officials spoke about the need to take steps as soon as possible to grow Vermont’s workforce, including investing in more housing so that workers can stay in or move to Vermont.  Department of Labor staff emphasized how Vermont’s available labor market has shrunk by about 26,000 workers over the past 2 years of the pandemic, a 7% contraction.  Only around 3000 individuals are still receiving unemployment benefits, and about ½ of the loss is due to workers retiring.  Notes from the press conference can be found here.

Officials did not address the COVID-19 pandemic at the press conference today, however notes from Commissioner of Health Mark Levine, MD calls with VMS can be found here and VAHHS last week can be found here. Vermont has seen an increase in COVID-19 cases this week, growing from an average of 261 to 283 (+8.5%) cases per day over the last seven days while testing was flat. Hospital admissions and inpatient numbers increased this week, with those hospitalized for COVID in Vermont growing 42% over the last seven days. However, the average number of Vermonters in the ICU has fallen this week. National modeling projects cases may ease slightly in the coming weeks, perhaps signaling the Omicron BA.2 variant wave could begin to subside in the Northeast.  The full DFR Modeling Report can be found here.

Other COVID-19 updates from the past week include:

  • First COVID-19 Treatment for Young Children: The U.S. Food and Drug Administration expanded the approval of the COVID-19 treatment Veklury (remdesivir) to include pediatric patients 28 days of age and older weighing at least 3 kilograms (about 7 pounds) with positive results of direct SARS-CoV-2 viral testing, who are: Hospitalized, or Not hospitalized and have mild-to-moderate COVID-19 and are at high risk for progression to severe COVID-19, including hospitalization or death.
  • Vaccines for Kids under 5: The Biden administration may now wait until as late as June to authorize a coronavirus vaccine for the nation’s youngest children, three people with knowledge of the matter told POLITICO.
  • Mask Order: CDC released a statement on masks in public transportation settings. To protect CDC’s public health authority beyond the ongoing assessment announced last week, CDC has asked DOJ to proceed with an appeal in Health Freedom Defense Fund, Inc., et al., v. Biden, et al. It is CDC’s continuing assessment that at this time an order requiring masking in the indoor transportation corridor remains necessary for the public health. CDC believes this is a lawful order, well within CDC’s legal authority to protect public health.
  • Hospitalizations of Children Aged 5–11 Years with COVID-19: CDC released an MMWR on hospitalizations of children aged 5–11 years with laboratory-confirmed COVID-19 in 14 states from March 2020 to February 2022. During the period of Omicron predominance, COVID-19–associated hospitalization rates in children aged 5–11 years were approximately twice as high among unvaccinated as among vaccinated children.

Health Care Committees Continue to Negotiate on Health Reform Bills

The House Health Care committee passed their version of the session’s health reform bill, S. 285, last week. The bill began in the Senate Health & Welfare Committee addressing recommendations of an off-session task force on health care accessibility and affordability. The version that has now passed the House committee was based on extensive discussions and input among stakeholders including VMS, other provider associations, AHS and the GMCB. In its current form, the bill addresses:

  1. steps the Agency of Human Services (AHS) needs to take in negotiating a subsequent agreement with CMS for Vermont’s All-Payer Model, including regular stakeholder input;
  2. requiring the GMCB to develop value-based payment models for Vermont hospitals or ACOs to move further away from fee-for-service models;
  3. requiring the GMCB to develop a plan for how to develop and engage stakeholders in a review of hospital services;
  4. moving the state closer to integrating clinical and claims data between the Vermont Health Information Exchange and VHCURES databases;
  5. the Agency of Human Services recommending amounts by which insurers and Medicaid should increase investments in the Blueprint for Health;
  6. a requirement that Vermont Medicaid either fund primary care services at 100% of Medicare in 2024 or inform legislative committees of the funding that would be need to do so;
  7. the Department of Financial Regulation to explore methods of accessing data from the Health Exchange to streamline the prior authorization process and to standardize the format of prior authorization data reported by insurers.

The bill has now been referred to the House Committee on Appropriations to discuss the funding allocated to AHS and the GMCB for the work outlined. H.353, a bill seeking to better regulate pharmacy benefit managers, was amended by the Senate Health and Welfare Committee and now would prohibit insurers from requiring use of medications sent directly to patients or health facilities (“brown-bagging” or “white-bagging”) without meeting certain safety and handling requirements.  Vermont insurance carriers are adamantly opposed to the amendment, claiming it will significantly drive up costs for the specialty drugs. The Senate Finance Committee has taken the bill in and will hear from the Department of Financial Regulation before it goes to the full Senate.

Action Alert: Please Email the House Government Operations Committee and Urge Support for THC Potency Caps

The Senate has removed current statutory THC potency limits for concentrated cannabis products in H.548, the miscellaneous cannabis bill.  VMS opposes this change, as high-THC products pose acute mental health and public health risks to Vermonters. Cannabis use of products with potency greater than 15% THC is associated with increased urgent and emergency department psychiatric visits and increased mental health disorders, including psychosis. It is also associated with increased urgent nonpsychiatric visits for respiratory distress, cannabis hyperemesis syndrome (uncontrollable vomiting) and poisonings. The bill will now go back to the House for them to review the changes. Please email the House Government Operations Committee and urge them to oppose the Senate-passed version that removes THC potency caps.  Click here for VMS testimony on H.548.

Please email House Government Operations Committee members: scopelandhanzas@leg.state.vt.us; JGannon@leg.state.vt.us; rlaclair@leg.state.vt.us; panthony@leg.state.vt.us; hcolston@leg.state.vt.us; mhigley@leg.state.vt.us; slefebvre@leg.state.vt.us; rhooper@leg.state.vt.us; mmccarthy@leg.state.vt.us; mmrowicki@leg.state.vt.us; tvyhovsky@leg.state.vt.us

Feedback Sought on Vaccine Notification Changes

The Vermont Board of Pharmacy at its monthly meeting tomorrow (4/27), will be considering a regulatory change to streamline reporting of vaccine doses administered in the pharmacy setting. Current rule requires pharmacies to (1) notify the patient's primary health care provider of the immunization administered; and (2) to report the vaccine delivered into the state immunization registry.  The Board of Pharmacy would like to streamline the process so that if a vaccine dose is reported to the registry the pharmacist would not also need to manually notify the primary care practice.  VMS is seeking feedback from members regarding this change and also whether enough information is reported to the vaccine registry, such as dose of the immunization administered.  Please send feedback as soon as possible to swinters@vtmd.org.

Feedback Needed: Reimbursement Differentials between Health and Mental Health Services

The Vermont Department of Financial Regulation plans to convene a stakeholder group to discuss reimbursement parity for mental health services across service modalities (in-person as well as via telehealth).  They are seeking further information regarding payment differentials between mental health/substance use providers and services and those for other health services – regardless of which gets paid at a higher amount.  Specifically it would be helpful to have examples of:

  1. Different reimbursement for MH/SUD providers from health insurers that have separate networks for those services (i.e., Beacon Health); and
  2. Differing reimbursement for MH/SUD providers and physical health providers billing the same code, like 99213 — even if it’s the MH/SUD provider that’s getting reimbursed more.

Please send examples to Jessa Barnard at VMS to gather feedback to share with DFR: jbarnard@vtmd.org. Feedback can be sent through Friday, May 13th.


Reminder: Mobile Crisis Services Survey Closes 4/29

The Agency of Human Services is conducting a mobile crisis services survey in partnership with Health Management Associates.  Please complete the survey by Friday, April 29, 2022.  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 Vermont Agency of Human Services (AHS) wants to hear your thoughts and experiences about mobile crisis services.

VMS Takes to the Road – No Cost Presentations Available for Your Practice

As medical practices and medical staffs once again begin to host in-person meetings, VMS is pleased to offer a menu of relevant speaker topics to bring no cost outreach and information to our members. Current topics include:

  • Clinician Wellbeing Workshops
  • Wellness Conversations
  • Update on Vermont Practitioner Health Program
  • Advocacy Skills Training
  • Vermont Legislative Update

See the descriptions and speaker bios available here.  Presentations are also available for remote meetings. For more information contact jbarnard@vtmd.org.  We look forward to connecting with our members!

Patient Educational Materials Available To Promote Colorectal Cancer Screening

The Vermont Medical Society is partnering with the American Society for Gastrointestinal Endoscopy (ASGE) to  encourage every physician in the state to visit the ASGE Colorectal Cancer Screening Appropriate Use web page to download patient education resources, including a printable office/practice poster, patient letter templates (for positive and negative test results), and an article for local newspapers.  Materials explain the colorectal cancer screening options based on patient age and risk including colonoscopy, fecal immunochemical test (FIT) and MT-sDNA (Cologuard). 

ASGE President Douglas Rex, MD, MASGE, explains, “More than 30 percent of U.S. adults aren’t getting screened for colon cancer and it’s a disease that has a 90 percent survival rate when detected early. Further, most cancers can be prevented through polyp removal at colonoscopy.  This campaign will save many lives.”  Physicians can also refer their patients to ASGE.org/Screening for an easy-to-understand infographic on the appropriate screening test.

CDC Health Alert Network: Children with Acute Hepatitis of Unknown Etiology 

After a cluster of children was identified with hepatitis and adenovirus infection, clinicians are advised to consider adenovirus testing in peds patients with hepatitis of unknown origin and to report such cases to public health authorities and the CDC. Learn more

CDC: School Entry Vaccination Rates Down

For the 2020–21 school year, school entry vaccination coverage with all state-required vaccines was approximately 94% for all required vaccines, approximately one percentage point lower than the previous school year. The exemption rate remained low at 2.2%. Disruptions caused by COVID-19 reduced reported enrollment, school response rates, and documentation for the 2020–21 school year.  Read more.

988 Suicide and Crisis Lifeline Launching this Summer

On July 16, 2022, Vermont will join the rest of the United States in beginning to use the 988 dialing code. 988 will be the new three-digit number for call (multiple languages), text or chat (English only) that connects people to the existing National Suicide Prevention Lifeline, where compassionate, accessible care and support are available for anyone experiencing mental health–related distress. People can use 988 if they are having thoughts of suicide, mental health or substance use crises, or any other kind of emotional distress. People can also dial 988 if they are worried about a loved one who may need crisis support.

Visit https://www.samhsa.gov/find-help/988 for more information about 988 services coming, including FAQs and a toolkit for partners and provider organizations to use in sharing information. 

Report: COVID-19’s Impact on Acquisitions of Physician Practices and Physician Employment 2019-2021

A recent study by Physicians Advocacy Institute and Avalere Health found a sharp acceleration in the ongoing trends of hospitals and other corporate entities, such as private equity firms and health insurers, acquiring physician practices and the correlating trend of physicians leaving private practice in the period following the onset of the Covid-19 pandemic.  Nearly 3 in 4 U.S. physicians were employed by hospital systems and other corporate entities by the end of 2021, leaving just 26% of the nation’s physicians practicing independently. In comparison, only one quarter of physicians were employed by hospitals or health systems in 2012.  See the key findings and full report here.


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. 

CMS Physicians, Nurses & Allied Health Professionals Open Door Forum:  

April 27, 2022, 2pm to 3pm (ET)

Conference Call

Topics include:

  • Open Payments Review and Dispute Update
  • Adopted HIPAA Standards for Health Care Electronic Funds Transfers (EFT)/Remittance Advice (ERA) Transactions and use of Business Associates
  • Open Q&A

Dial: 1-888-455-1397 & Conference Passcode: 5109694

3rd Annual Teaching Cannabis Awareness and Prevention 2022 

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


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.

Northern New England Society of Addiction Medicine 2022 Scientific Session and Business Meeting

May 7, 2022, 8am to 4:15pm


Join NNESAM for presentations including Telehealth the New Normal, Opioid Risk in Recovery Residences, and more on May 7th for a maximum of 6 AMA PRA category 1 credits. The business meeting will be held from 8am to 9am followed by the scientific meeting from 9am to 4:15pm.

To register and view the complete brochure with the schedule of events, click here.

Clinician Information Sessions: New 2022 DNR/COLST Form

May 11, May 26, 2022, 12pm to 1:15pm


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.

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.

Caring for Adolescents and Young Adults with Disordered Eating: A Multidisciplinary Training

May 23, 2022, 9am to 4:00pm


Learn how to apply a multi-disciplinary approach to caring for adolescents and young adults with disordered eating, identify best practices for case conceptualization, assessment, and intervention to apply, and more with presenters from the UVMMC Eating Disorder Consultation Clinic, The Adams Center, UVM, and panelists from the field. View the full flyer with the learning objectives and agenda 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.


Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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