June 11, 2024

NEED TO KNOW

Governor Continues Taking Action on Legislation - Most Include Studies

The sheer volume of bills the Legislature introduced and passed this year has kept the Governor very busy since the gavel fell on May 15th. He has one week to get through any remaining bills on his desk before the June 17 veto session. This past week the Governor took action on several bills the VMS policy team has been following throughout the session and almost all of these bills include at least one study that will inform future policies in 2025 and beyond. This week the Governor:

• Signed H.622, an emergency medical services (EMS) bill, which includes the creation of an EMS Advisory Committee that will start with a complete inventory of Vermont's EMS system to inform recommendations on how to best design a statewide EMS system that optimizes patient care and incorporates nationally recognized best practices;
• Signed H.870, this year's OPR bill, which includes the creation of a Naturopathic Physicians Technical Advisory Group, of which the Vermont Medical Society is a member. The Technical Advisory Group is charged with providing recommendations to the House and Senate Health Care and Government Operations Committees on authorizing naturopathic physicians to participate in Vermont’s Patient Choice at End of Life law, do not resuscitate (DNR) orders and advanced directives, and clinician orders for life-sustaining treatment (COLST);
• Signed S.302, a bill that requires the Departments of Health, Mental Health and Disability, Aging and Independent Living to work with the Commission of Alzheimer's Disease and Related Disorders to educate health care providers and increase public awareness of the early warning signs of Alzheimer's disease and other types of dementia and the benefits of early detection; 
• Signed S.98, a bill that requires the Green Mountain Care Board to study and create a framework to implement a program to regulate the cost of prescription drugs for Vermont's consumers and health care system. They need to present the preliminary recommendations in January 2025 and final recommendations in January 2026.
• Allowed H.612, this year's miscellaneous cannabis bill, to go into law without his signature. Among other things, the law allows sale of medical cannabis products in any retail store with a medical “endorsement” and requires applicants to the medical program who are under age 21 to obtain a medical verification form from a health professional with whom they have had a least a 3 month treatment relationship.  Governor Scott provided an explanation for why he did not sign the bill in a letter (not currently available online), which includes the concern Vermont health care providers have cited that the availability of high potency medical cannabis products in more retail stores will increase use of high potency products among those who do not have a valid medical verification. This law contains several studies including two that the Vermont Medical Society are named to participate in: an analysis of advertising restrictions and an assessment of the Medical Cannabis Program. The VMS is seeking members who would like to participate in these studies, if you are interested please reach out to Jill at jsudhoffguerin@vtmd.org
• Signed S.114, a bill that creates a Psychedelic Therapy Advisory Working Group to review existing data on the benefits of using psychedelics to improve mental health. The VMS is seeking members who would like to participate in these studies, if you are interested please reach out to Jill at jsudhoffguerin@vtmd.org

Here is the full list of bills the Governor has taken action on this session. Previously, the Governor also passed the FY25 budget (H.883) and the prior authorization bill, H.766, which also include relevant studies for VMS members. The FY25 budget contains several health care studies, including:

• Proposed Methodology for RBRVS fee schedule: By January 15th, 2025, the Department of Vermont Health Access must meet with stakeholders and report back to the legislature on a Medicaid RBRVS fee schedule methodology for 2025 that considers a floor to the “conversion factor” used so that the Medicaid fee schedule does not decrease if the Medicare fee schedule decreases;  
• Vermont Health Insurance Market Analysis: By January 15th, 2025, the Agency of Human Services (AHS) must complete a technical analysis of Vermont's health insurance markets to determine the potential impact on premiums and access to care if the State modifies the current insurance market. This analysis must include an examination of the feasibility of creating a public option or other mechanism through which otherwise ineligible individuals or employees of small businesses, or both, could buy into Vermont Medicaid coverage. 
• Medicare Savings Program Eligibility Expansions Impact on VPharm: By January 15th, 2025, AHS will provide recommendations on whether the VPharm program needs to be modified or repealed due to an eligibility expansion of Vermont's Medicare Savings Program contained in the state budget.

The prior authorization bill also contains several studies and after the Governor signed the bill into law, he issued a letter saying he directed AHS and the Department of Financial Regulation (DFR) to jointly study how the legislation will impact health insurance rates, health care costs and outcomes and how it fits with Vermont's health reform goals. He also directed the Green Mountain Care Board to identify the cost savings associated with reduced prior authorizations and to find ways to pass on this savings to consumers. The bill, now Act 111, requires that insurers and health care professionals provide prior authorization impact reports.  

Vermont Physicians Represented at AMA Annual Meeting

The American Medical Association Annual Meeting is taking place this week in Chicago, IL.  AMA policy is set by a House of Delegates made up of state and national specialty society representatives.  Vermont is represented by delegate Norman Ward, MD, and alternate delegate Catherine Schneider, MD (pictured above, speaking to the House of Delegates). Other Vermonters attending the meeting this year include VMS President Rebecca Bell, MD, who will participate in the AMA presidential inauguration this evening, and radiology delegate Naiim Ali, MD, who is also VMS Vice President.  Highlights from the meeting can be found here. One resolution that obtained significant attention initially called for a ceasefire in Israel and Palestine and was ultimately amended and adopted to call for peace in Israel and Palestine and support for the safety of healthcare and humanitarian aid workers and access to health care and health care facilities in all areas of armed conflict. 

MISC.

Next Commissioner Call Thursday, August 1, 2024

The Commissioner of Health, Mark Levine, MD, will hold his next Public Health Update with VMS Members Thursday, August 1st at 12:30 pm. You can join the zoom meetings here.

He held his most recent VMS member call on June 6th. Notes from the call are here.

VMS Member Survey – We Want to Hear From You!

The VMS Board will be holding its annual planning retreat on Wednesday, June 26th.   To help inform the retreat and planning for 2024-2025 we would like to hear from you!  What is VMS doing well, what should we do more of, are our priorities on track?  This is a quick, 4-question survey and should only take a few minutes. The survey will be open for member comment between May 28 and June 18, 2024. Last week you should have received an email with a survey link specific to you. If you did not receive your survey link or have any questions or concerns with completing the survey, please contact bpauley@vtmd.org.

Thank you for your membership and letting us know how we can support your practice of medicine. 

EVENTS

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.

Birth Certificate Quality Improvement Initiative Learning Series

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.

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 --