May 31, 2022

NEED TO KNOW


VMS Releases End of Session Legislative Report


The VMS Policy Team thanks our members for your commitment to advocacy and reaching out to legislators throughout the 2022 legislative session. We know this takes time away from your patients, families and other commitments, but it makes a significant impact when legislators hear from you directly. At the close of the 2021-2022 biennium, we thank you and celebrate our many policy successes. Together with you, we moved the needle on the VMS policy priority to bolster primary care: successfully advocating for three no-cost share primary care and mental health care visits in every standard health insurance plan; achieving Medicaid payments for primary care services equal to 100 percent of Medicare payments; and requiring insurers to report back on the efficacy of prior authorizations. Other policy successes include:


  • Vermont Medical Student Incentive Scholarship in the FY23 Budget: Funding for a new Vermont Medical Student Incentive Scholarship was put into statute in 2021 and the FY23 budget continues to fund up to ten scholarships per year for graduates of the Larner College of Medicine who commit to practicing primary care in Vermont;
  • Vermont Health Care Professional Loan Repayment Program in the Workforce Development Bill (S.11): AHEC will oversee a new health care professional loan repayment program, which includes $500,000 for child psychiatrists and primary care providers who live and work in the State;
  • Cannabis Potency Caps Retained – 30% for flower, 60% for solid concentrates in S.188;
  • Expanded Optometrist Scope of Practice Bill Dies (S.158): After a herculean effort from Vermont physicians, a bill seeking to allow optometrists to perform surgical procedures died in Committee;
  • Prop 5: The constitutional amendment protecting reproductive liberties for every Vermonter passed every required step in the Legislature and will now go before the voters on the general election ballot in November.

These are only a handful of VMS’s successes this session. Click here for our 2022 Final Legislative Bulletin, which provides a comprehensive summary of all of the 2022 health care policies that will impact your practice and profession. We also welcome invitations to speak to your medical staff or practice to give a legislative update – email jbarnard@vtmd.org.

COVID-19 Updates: COVID-19 Rebound After Paxlovid Treatment

There was no administration press conference this week discussing COVID-19, as the Governor will be holding a press conference tomorrow focused on rehousing people exiting homelessness. VMS will be hosting our bimonthly call with Commissioner of Health Mark Levine, MD, this Thursday, June 2nd from 12:30-1pm. Join the Zoom Meeting -https://us02web.zoom.us/j/86726253105?pwd=VkVuNTJ1ZFQ2R3diSVdqdlJ2ZG4yQT09. The weekly surveillance report is available here.

In other COVID-19 updates:

  • The CDC last Thursday issued a Health Alert Network (HAN) Health Advisory to update healthcare providers, public health departments, and the public on the potential for recurrence of COVID-19 or “COVID-19 rebound.”   Paxlovid continues to be recommended for early-stage treatment of mild to moderate COVID-19 among all persons at high risk for progression to severe disease. There is currently no evidence that additional treatment for COVID-19 is needed for COVID-19 rebound. Based on data available at this time, patient monitoring continues to be the most appropriate management for patients with recurrence of symptoms after completion of a treatment course of Paxlovid. Advise people with COVID-19 rebound to follow CDC’s guidance on isolation and take precautions to prevent further transmission. Read the full HAN here.
  • The Vermont Immunization Program anticipates the long-awaited approval of a COVID-19 vaccine for those six months to 5 years in the coming weeks. Moderna and Pfizer are in the final stages of the regulatory process, with VRBPAC meetings scheduled on June 14 -15 to discuss amending the EUA for both products. We expect that practices will be able to order this vaccine for prepositioning the week of June 6, with a delivery date of the week of June 20. Based on information shared from the CDC, we are confident that ample stock will be available to serve the approximately 26,000 Vermont children who will become eligible. The Immunization Program has developed a Communication Toolkit for practices to use with their families. It is also available on the Health Care Professional website.
  • State testing sites are winding down through May and June. Patients can still pick up take-home tests from state testing sites until then and households can order a 3rd round of free tests from the federal government at https://www.covid.gov/tests.

    Governor Reminders Vermonters of Available Mental Health Resources

    In the wake of a number of violent acts in the recent weeks, coupled with the ongoing pandemic and international turmoil, the Governor reminded Vermonters of the mental health resources available to them in statement released to the press on May 26th.

    In his statement he noted that “Part of the challenge is a general feeling of powerlessness. Know that there are actions you can take as an individual. Reach out to people around you, especially people who may be isolated or alone, or if you are feeling isolated and alone.”  He also listed resources that could be accessed 24 hours a day, 7 days a week.     Read the full statement here.

    Vermont Health Department Calls on Pediatricians and Family Practitioners to Address Declines in Lead Testing

    Vermont law requires that all children are tested for lead at 12 months and 24 months. Unfortunately, the pandemic and the LeadCare II test kit recall have led to significant declines in lead testing. The percentage of 1 year olds tested decreased from 75% in 2019 to 69% in 2021, and the percentage of 2 year olds tested decreased from 72% in 2019 to 62% in 2021.

    Pediatricians and Family Practitioners can help by testing all 1 and 2 year old children at their well child visit, educating families about lead exposure, and ensuring that children who missed their lead screening are tested as soon as possible.

    Check out the May 16 article from AAP News: CDC calls on pediatricians to address challenges in lead poisoning prevention

    In addition, effective July 1, 2022, Vermont’s Pediatric Blood Lead Testing Guidelines will require any detected and reported level of lead to be monitored. No level of lead exposure or blood lead level is safe, and even low levels can impact neurodevelopment.

    You can find more information and resources at healthvermont.gov/lead/providers or you can contact the Healthy Homes Lead Poisoning Prevention Program at 802-863-7220 or AHS.HealthyHomes@vermont.gov.

    VMS Resolution-Adoption Process – Help Direct the Work of YOUR Society

    VMS welcomes members to submit resolution ideas! Resolutions set the policy positions of VMS and often drive VMS advocacy work at the state and federal levels.

    The VMS resolution-adoption process was modified in 2021 via an update to the VMS Bylaws. Resolutions may now be submitted on a year-round basis, any time by any committee or section of the Society, the Board or individual members of the Society, including student members. Resolutions are intended to express composite positions of the VMS and are to suggest a significant course of action to be taken by the Society. To see adopted VMS resolutions, click here.

    Typical resolution-adoption procedures include:

    • Once a resolution idea is submitted by a member, the resolution will be reviewed by VMS staff, who may assist with further drafting or clarification.
    • Resolutions are then distributed for comment and non-binding survey to all membership.
    • At a Board meeting after gathering member feedback, the VMS Board will review the resolution and feedback of membership. Typically, the author(s) of resolution will also be invited to present the resolution and VMS members will be invited to attend the meeting to participate in the discussion. All resolutions presented to the Board then require a majority vote of the Board for action, including adoption, amendment, or referral.

    To submit a resolution idea, please fill out the form, available here or contact jbarnard@vtmd.org for further assistance.

    MISC.

    Health Insurance Industry Continues to Falter on Prior Authorization Reform

    Despite mounting evidence that insurer-imposed authorizations for drugs and medical services can be a hazardous and burdensome administrative obstacle to patient-centered care, the health insurer industry continues to show apathetic or ineffectual follow-through on mutually accepted reforms, according to new physician survey results (PDF) released by the American Medical Association (AMA) last week. Given the health insurance industry’s lack of progress toward voluntarily expediting comprehensive prior authorization reform, the AMA and other physician organizations are calling on Congress to remedy the problem. The Improving Seniors’ Timely Access to Care Act (HR 3173 / S 3018) takes direct aim at the insurance industry’s foot-dragging.  In Vermont, VMS advocated for Section 36 of S. 11, pending for the Governor’s signature, which directs the Department of Financial Regulation to study accessing data from VITL (Vermont’s health information exchange) to complete prior authorizations and also directs DFR to require health insurers to submit standardized data on prior authorizations to analyze opportunities to align and streamline prior authorization request processes.  VMS was also successful in 2020 (Act 140) in requiring all Vermont health insurers to implement a “Gold Card” program to exempt clinicians who have a high rate of PA approval from the PA process by 2022. 

    Applications Open until June 1 - Vermont Premium Pay for Workforce Recruitment and Retention Program

    The Agency of Human Services (AHS) has opened a grant opportunity per Act 83 of 2022 to certain health care and social services employers. The Program allows Eligible Employers to apply to receive $2,000 per full-time equivalent employee (FTE) to distribute Premium Pay to Eligible Employees who commit to continuing employment with the Eligible Employer for at least one calendar quarter following receipt of the payment.  Eligible employees include those who provide regular, in-person interactions with patients and/or the public and includes front line staff, nurses, PAs, mental health clinicians, and psychiatrists. Eligible Employers include assisted living residences, nursing homes, residential care homes, home health agencies, designated agencies, substance use treatment providers, recovery centers, adult day service providers, area agencies on aging and DCF residential treatment programs.   Access program materials at http://humanservices.vermont.gov/recruitment-and-retention.  Applications opened May 18th and the application deadline was recently extended from May 24th to June 1st.

    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!

    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. 

    Medical Societies Adopt Medicare Payment Reform Principles

    Led by the American Medical Association, 120 organizations including the Vermont Medical Society recently endorsed Characteristics of a Rational Medicare Physician Payment System. This set of principles provides a framework for payment reform as an early step in our effort to develop consensus across medicine on policy recommendations that will reshape the payment system so that it works better for patients and physicians, and put an end to the annual advocacy exercise of stopping impending payment cuts. 

    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. 

    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. 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.

    VMS Compliance Update Webinar: Effective Communication (Translation/Interpretation) Services

    June 9, 2022, 12:30pm to 1:30pm EST

    Virtual

    Representatives from the US Department of Health and Human Services Office for Civil Rights will be presenting on the legal obligations of healthcare clinicians to provide effective communication under Section 504 of the Rehabilitation Act, Title II of the American with Disabilities Act, Section 1557 of the Affordable Care Act, and Title VI of the Civil Rights Act.  The presentation will focus on ensuring that healthcare practices provide effective communication to individuals with disabilities as well as individuals with Limited English Proficiency, and will include a discussion of recent effective communication settlements agreements.  Open to VMS members, office/compliance staff and any others interested in this important topic. 

    Register in advance for this webinar here.

    Strategies for Distributing Naloxone to Rural Communities

    July 13, 2022, 12pm to 1pm EST


    Join the UVM CORA Community Rounds Workshop series session on, “Strategies for Distributing Naloxone to Rural Communities.” Our speakers are Geoff Capraro, MD, and Brooke Lawrence, co-founders of NaloxBox, an organization whose mission is to reduce harm from opioid use disorder by improving access to naloxone. This presentation will explore the need for naloxone distribution in rural areas and discuss innovative methods and technologies for increasing access.

    REGISTER HERE

    Can't make it? Watch the webinar recording to claim Continuing Education credits (within one month of the live event). Register for the webinar before July 13th so that you'll receive the recording later!


    Vermont ACP Chapter Annual Scientific Meeting

    October 14, 2022

    Trapp Family Lodge, Stowe, VT

    The Vermont ACP Chapter's Annual Scientific Meeting will occur on Friday, October 14, 2022. The ACP is optimistically planning for an in-person meeting. The ACP will host a virtual poster competition for resident and student members.

    Update your medical knowledge, engage with colleagues, and receive CME credits and MOC points.

    Meeting details and agenda forthcoming.

    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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