May 14, 2024

NEED TO KNOW

Final Countdown to Gov Scott’s Decision on H. 766 Begins!  Tell Him H.766 is Good for Patients and Clinicians

This is the week the prior authorization reduction bill, H. 766, heads to Governor Scott for his consideration.  VMS believes the bill is headed to him today, meaning he will have until Monday 5/20 to decide whether to sign, veto or allow to the bill to go into law without his signature.  Contact his office today at 802-828-3333 or email https://vermontce.my.vermont.gov/s/governor-office-ce to tell him that reducing insurance delays and paperwork is good for Vermont patients and clinicians! 

According to VT Digger, the Governor has signaled that he “understands that there could be benefits, creating efficiencies and improving patient experiences…so, he will weigh those out once it reaches his desk.” Yesterday, insurers also filed proposed 2025 rates indicating cost impacts of H. 766. So your comments this week explaining the benefits and the fact that insurer estimates do not take into account care provided in more expensive settings or the administrative costs of PA are very important! See talking points related to the cost estimates of H. 766 here.

A final version of the bill as passed the legislature is now available here.  The bill will apply to state regulated commercial insurance plans in Vermont (MVP, BCBSVT and Cigna plans sold on the exchange) and:  

1. Prohibit insurers from applying any prior authorization to primary care clinicians (excepting prescriptions and out of network care);
2. Require insurers to cover, without requiring prior authorization, at least one readily available asthma controller medication from each class of medication and mode of administration;
3. Reduce the time frames for health plans to respond to prior authorization requests to 24 hours for urgent requests;
4. Require authorization of treatments and medications to last for at least one year – and require authorizations for ongoing treatments to last 5 years.
5. Require health plans to allow requests for exceptions to prescription drug step-therapy under specific conditions, like if a patient is stable on an existing therapy or if the drug is expected to be ineffective;
6. Mandate adherence to coding standards and guidelines for processing healthcare claims and prohibit prepayment claims edits (ending a burdensome Blue Cross Blue Shield of Vermont policy that requires prepayment review of certain claims, including those used with Modifier -25 and -59); and
7. Limit claims edits for services other than pharmacy to those instances when Medicare uses claim edits.

For a patient summary of the bill, patient poster and social media graphic, visit https://vtmd.org/yeson766/.

Final Gavel on 2024 Legislative Session Last Friday

Lawmakers left Montpelier at 2am this past Saturday morning, heading home after what many called the hardest session they had experienced. The last day was indicative of the entire 2024 legislative session, in which lawmakers fought hard defending their positions, rather than focus on compromise and agreement. The dust has not fully settled, as we are waiting for the final version of bills that passed last week and are also waiting to see what action the Governor will take on several priority bills. The Legislature is scheduled to return on June 17th for a one-day veto session with the Governor indicating he will likely veto several bills including:

• H.121, a data privacy bill that still includes a private right to sue over violations of the law, but, as passed, now also includes an entity-level exemption for HIPAA covered entities or health care components of HIPAA covered entities that are hybrid entities  – which VMS fought hard to include in the last days of the session; and
• H.72, an overdose prevention center bill, which would pilot one overdose prevention site in Burlington.

Other updates from the last days of the session include:

• H.612, the miscellaneous cannabis bill, did pass before the gavel fell but many said it was rushed legislation with many of the provisions turned into studies, including rule-making for a new medical endorsement program for recreational cannabis shops.
• H.721, the Medicaid expansion bill that was a priority for both House and Senate Health Care Committee leaders, failed to make it across the finish line, although an expansion of the Medicare Savings Program advanced in the state budget and will expand help paying for Medicare out of pocket costs to an additional 12,000 low income Vermonters.
• H.861, a VMS-priority bill that requires parity for reimbursement for telehealth services, including audio-only, was signed into law by Governor Scott yesterday. This law becomes effective January 1, 2025.
• H. 766, the prior authorization bill, will be headed to the Governor imminently. See the action alert above!

We will send a full session summary after the veto session is completed.  Thank you to our members for weighing in on so many health care priority bills this session – especially your testimony, phone calls and emails regarding H. 861 (telehealth) and H. 766 (prior authorization).  We also extend a huge thank you to the Representatives and Senators who put in hours to learn about the perspective of health care professionals and fought for bills to make the health care experience better for clinicians and patients, especially members of the House Health Care Committee including chair Lori Houghton and vice chair Alyssa Black; Chair Virginia Lyons and members of the Senate Health and Welfare Committee; and Chair of the Senate Economic Development Committee Kesha Ram Hinsdale.

MISC.

AHRQ Safety Program for Telemedicine: Improving Antibiotic Use

The AHRQ Safety Program for Telemedicine: Improving Antibiotic Use, led by NORC at the University of Chicago and Johns Hopkins Medicine, is recruiting primary care practices, community-based health centers, specialty practices that provide primary care, and urgent care clinics to learn about adapting antibiotic stewardship efforts for the telemedicine environment. Practices may provide care exclusively via telemedicine or in addition to in-person visits. 

• Practices will learn about and implement best practices in antibiotic use in the telemedicine environment through short educational presentations and support from experts.
• There is no cost to participate.
• Participating staff can earn CEUs, CMEs, and ABIM MOC points

The deadline to enroll is May 23, 2024. Learn more at https://safetyprogram4telemedicine.org/.

Commissioner Call Thursday, June 6, 2024

The Commissioner of Health, Mark Levine, MD, will hold his next Public Health Update with VMS Members Thursday, June 6th at 12:30 pm. You can join the zoom meetings here.

He held his most recent VMS member call on April 4th. Notes from the call are here. 

EVENTS

May 21, 2024

In-Person Lake Morey Resort in Fairlee, VT

Now is the time to Reinvent Normal. As everyone talks about getting back to normal, this talk asks the big question: Why? Was your old normal everything you wanted it to be. At work and at home, it’s time to break old habits and routines? It’s time to make things better. Reinventing Normal helps you learn how to stay positive, build resilience, live with uncertainty, and find and use your skills to make you a better leader -- and a better follower. Don’t miss the opportunity to build new. You will learn and laugh a lot while he takes us on the adventure of making your new normal not just productive, but also fun, positive, and hopeful.

Registration Information and full agenda  can be found here.

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.

Birth Certificate Quality Improvement Initiative Learning Series

June 10, July 15, September 9, October 7, 2024

Virtual

In collaboration with the Vermont Department of Health Division of Family and Child Health and the Division of Health Statistics and Informatics, the Perinatal Quality Collaborative - Vermont (PQC-VT) is embarking on a vital statistics birth certificate quality improvement initiative (BCQII).

The project aim is to improve the accuracy of key birth certificate variables to support public health and quality improvement efforts. The objective is to increase birth certificate data quality in Vermont by providing education opportunities, technical assistance, and shared learning to Vermont hospital teams involved in birth certificate data collection.

Register here for the learning series.

Xylazine Trends and Public Health Implications for Rural Communities 

Virtual, June 12th, 12pm to 1pm ET

Please join us on Wednesday, June 12th from 12:00 p.m. - 1:00 p.m. ET for a UVM CORA Community Rounds Workshop Series session, “Xylazine Trends and Public Health Implications for Rural Communities.” Our speaker is Michael Chaple, PhD, Assistant Professor of Clinical Psychiatry at Columbia University Irving Medical Center, and Director of the Northeast and Caribbean Rural Opioid Technical Assistance Center. This presentation will provide an overview of xylazine, current data on prevalence and other trends associated with its use, and will also discuss the public health implications associated with xylazine use. This presentation will also offer harm reduction strategies for mitigating the public health impact of xylazine. Throughout the presentation, unique implications for rural communities will be systematically addressed.

Register 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.

Reducing Barriers to Physician PTO

Virtual, June 18 at 12 pm CT

Curious about how to overcome barriers to personal time off (PTO) at your health care organization? Join us for a webinar and live Q&A with Jill Jin, MD, MPH, and Marie Brown, MD, MACP.

Learn more here.

Saving Time: Practice Innovation Boot Camp

September 23 - 24 AMA Plaza, Chicago

This two-day, interactive boot camp from the AMA STEPS Forward® Innovation Academy equips attendees with the time-saving tools and strategies needed to reform their organizations and enhance professional satisfaction. CME eligible.

Learn more here.

Vermont ACP Chapter Annual Scientific Meeting

October 18, 2024

Trapp Family Lodge, Stowe, VT

The Vermont ACP Chapter's Annual Scientific Meeting will occur on

Friday, October 18, 2024.

This will be an in person meeting. We will

again host a poster competition for resident and student members.

Update your medical knowledge, engage with colleagues.

Meeting details and agenda forthcoming.

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

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

-- Unsubscribe --