June 18, 2024

NEED TO KNOW

AMA Annual Meeting Concludes in Chicago

The AMA Annual Meeting met last week in Chicago.  Vermont was represented in the House of Delegates, which adopts AMA policy, by delegate Norman Ward, MD, and alternate delegate Catherine Schneider, MD.  The AMA adopted and strengthened a number of policies during the meeting, including those calling for additional reform of Medicare Advantage plans and uncoupling payment schedules from a Medicare benchmark – a problem in Vermont with Medicaid payments being linked to decreasing Medicare payments.  See additional highlights from the meeting here.   Pictured above, VMS President Rebecca Bell, MD, also joined for the inauguration of AMA President Bruce Scott, MD, and past Vermont delegates Robert Tortolani, MD, and Dick Butsch, MD, also traveled to the meeting to attend the Senior Section and New England Delegation meetings.   

2024 Legislature Officially Wraps After One-Day Veto Session

Legislators returned to Montpelier yesterday for a one-day veto session and overrode 6 out of the 8 bills the Governor vetoed this legislative session, including overriding the veto of H.72, a bill that will pilot one overdose prevention center in Burlington. In order to override, each chamber needed to receive affirmative votes from 2/3 of the number of lawmakers who attended the veto session, which made all of the votes very tight in the Senate with only 29 Senators present. In the case of H.72, the House quickly overrode the veto, but the Senate only successfully overrode after one lawmaker asked for a reconsideration. H.121, a data privacy bill, was the only bill the Legislature failed to override, excepting S.18, the flavored tobacco bill, which they did not take up for a vote to override after Governor Scott vetoed it earlier this spring. Click here to see all actions taken by the Governor. 

As part of this action-packed day the Legislature also passed H.890, a bill that amends H.766/Act 111by pushing back the effective date of portions of Section 2 requiring payers to align their claims edits with Medicare's edits standards to January 1, 2026. A prohibition of prepayment audits and a creation of the claims edit working group will retain the original effective date of January 1, 2025. The legislature agreed to move the effective date after the Department of Financial Regulation expressed concern about the impacts on the insurance market of requiring implementation by January 1, 2025.  Learn more about the new 2024 health care laws when VMS publishes a 2024 Final Legislative Bulletin next week.

Save the Date - VMS Annual and Collaborative Meeting on November 1st to 2nd

The 211th VMS Annual and Collaborative Meeting will be held on November 1st and 2nd in-person with virtual options at Topnotch Resort, Stowe, VT. The weekend will be filled with educational content, time spent with colleagues, policy-setting meetings, and the opportunity to honor physicians and other health care leaders across the state.

Stay up to date on details here and submit nominations for Vermont leaders who have provided outstanding contributions to the medical profession, to health organizations and to the welfare of the public for a VMS Leadership Award here.

Options for Hospital Transformation to Be Presented at GMCB and In-Person Community Meetings Across Vermont

In response to national trends, deteriorating hospital and provider financial health, increasing costs for Vermonters, and gaps in access to local mental healthcare, primary care, and long-term care, the legislature in 2022 directed the Green Mountain Care Board (GMCB) to retain a consultant to develop recommendations for hospital transformation. The GMCB retained Dr. Bruce Hamory and the Oliver Wyman’s Health and Life Sciences Practice to hear directly from Vermonters, clinicians and hospitals about current experiences with the healthcare system.  Read more about the work to date here.

Dr. Bruce Hamory and team will share their findings and options for transformation of Vermont’s healthcare system at GMCB’s public board meetings on June 19 and July 8. Public, in-person community meetings will run from July 9^th through August 5^th and will include community and hospital specific options for improving access, constraining cost and improving health equity. The purpose of these meetings is to review the findings and options and provide additional opportunity for input.  The options presented will be broad and include state-level changes to be considered by the Vermont Legislature or health-related government agencies, hospital-level changes for hospital leadership and hospital boards, cross-hospital options for multiple hospitals to coordinate services, and community-level options to facilitate health and healthcare access through changes in transportation and housing infrastructure.

Meeting schedule

State-Level Recommendations to Support Hospital Transformation at GMCB Board Meeting

• June 19 meeting begins at 1 pm via Microsoft Teams

Kick-Off and Preview for Healthcare Community Conversations at GMCB Board Meeting

• July 8 meeting begins at 10 am via Microsoft Teams

14 In-Person Community Meetings

• Meeting Schedule with locations and sign-up links (RSVP optional)

July 9th 6:00 - 7:30 pm - Newport / North Country Hospital

July 10th 6:00 - 7:30 pm - St. Albans / Northwestern Medical Center

July 11th 6:00 - 7:30 pm - St. Johnsbury / Northeastern Vermont Regional Hospital

July 15th 6:00 - 7:30 pm - Windsor / Mt. Ascutney Hospital and Health Center

July 16th 4:30 - 6:00 pm - Springfield / Springfield Hospital

July 17th 6:00 - 7:30 pm - Brattleboro / Brattleboro Memorial Hospital

July 18th 6:00 - 7:30 pm - Townshend / Grace Cottage Hospital

July 22nd 6:00 - 7:30 pm - Morrisville / Copley Hospital

July 23rd 6:00 - 7:30 pm - Barre / Central Vermont Medical Center

July 24th 6:00 - 7:30 pm - Randolph / Gifford Medical Center

July 29th 4:30 - 6:00 pm - Burlington / University of Vermont Medical Center

July 30th 6:00 - 7:30 pm - Middlebury / Porter Medical Center

July 31st 6:00 - 7:30 pm - Rutland / Rutland Regional Medical Center

August 1st 4:00 - 5:30 pm - Bennington / Southwestern Vermont Medical Center

August 5th 6:00 - 7:30 pm - State-wide / All Hospitals

CDC HAN Advisory: Severe Illness Potentially Associated with Consuming Diamond ShruumzTM Brand Chocolate Bars, Cones, and Gummies

The Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), America’s Poison Centers, and state and local partners are investigating reports of severe acute illnesses potentially associated with consuming Diamond ShruumzTM brand chocolate bars, cones, and gummies marketed as containing a proprietary blend of mushroom. As of June 11, 2024, 12 total illnesses and 10 hospitalizations have been reported in eight U.S. states with ongoing efforts to identify other potential cases. The cause of the reported illnesses is not known at this time. Individuals should not eat, sell, or serve any flavors of Diamond ShruumzTM brand chocolate bars, cones, or gummies, and should discard products that have been purchased. CDC and FDA are working to determine whether other products from this company are associated with adverse health effects.

Learn more here.

CDC HAN Advisory: Disrupted Access to Prescription Stimulant Medications Could Increase Risk of Injury and Overdose

The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to inform public health officials, clinicians, and affected patients, their families, and caregivers about potential disrupted access to care among individuals taking prescription stimulant medications and possible increased risks for injury and overdose. On June 13, 2024, the U.S. Department of Justice announced a federal health care fraud indictment against a large subscription-based telehealth company that provides attention-deficit/hyperactivity disorder (ADHD) treatment to patients ages 18 years and older across the United States. Patients who rely on prescription stimulant medications to treat their ADHD and have been using this or other similar subscription-based telehealth platforms could experience a disruption to their treatment and disrupted access to care. A disruption involving this large telehealth company could impact as many as 30,000 to 50,000 patients ages 18 years and older across all 50 U.S. states. 

Learn more here.

Upcoming Webinar | Measles: Stories from the Frontlines | June 27, 1 pm CT

Join the CDC and AMA on June 27 at 1:00 pm CT for a panel discussion on preventing widespread measles exposure in health care settings in the upcoming webinar, “Measles: stories from the frontlines.”

Our panel includes experts from the Pediatric Pandemic Network, American Nurses Association and American Academy of Pediatrics. They will share their experiences in:

• Caring for patients with measles
• Implementing effective infection prevention practices
• Enhancing awareness for triage personnel in emergency departments, outpatient clinics, and urgent care settings

Register and submit your questions in advance.

Don’t miss this important conversation. The webinar will be recorded if you cannot attend the live session.

We look forward to your participation and please share with your network.

MISC.

Supreme Court Decision Maintains Access to Mifepristone for Abortion

The AMA, ACOG and other medical associations released statements last week supporting the unanimous Supreme Court decision finding that the doctors who brought a challenge to the FDA approval of mifepristone did not have standing to sue.  While the decision upholds access to mifepristone, for an analysis of the ruling and why this may not be the end of legal challenges for the medication, read more here. For the AMA statement on the ruling and links to the AMA brief in the case, click here. 

VT Immunization Program Update Meeting Scheduled for July 11

The Immunization Program will be hosting a quarterly meeting to provide information on ACIP updates, vaccine updates, and other relevant information. In addition to providing information, time will be available for questions and discussion. Please consider attending and inviting colleagues to attend. A recording of the event will be made available for those unable to attend.

If you need an invite, please email jessica.buchanan@vermont.gov

For more information and links to the monthly Vaccine Program e-newsletters, see: https://www.healthvermont.gov/disease-control/immunization-health-care-professionals

VMS & AMA-Supported Prior Authorization Bill Reintroduced in Congress

On June 12, bipartisan lawmakers introduced an updated version of the Improving Seniors’ Timely Access to Care Act in both the House (H.R. 8702) and Senate (S. 4532). The VMS and AMA are proud to support the latest version of this legislation.  Efforts to reform PA at the federal level complement state efforts, such as H. 766, which passed the Vermont legislature this session. 

“This legislation will streamline the prior authorization process so physicians can offer patients safe, timely and affordable care,” said AMA President Bruce A. Scott, MD. “Those decisions should be made between patients and their doctors without being second-guessed by insurers. The bipartisan and bicameral support for the bill is evidence that this is a common-sense proposal that deserves to be passed.” Contact your representative and senators today and ask them to support the Improving Seniors' Timely Access to Care Act.

Specifically, the bill would:

• Establish an electronic prior authorization process for MA plans including a standardization for transactions and clinical attachments.
• Increase transparency around MA prior authorization requirements and its use.
• Clarify CMS’ authority to establish timeframes for e-PA requests including expedited determinations, real-time decisions for routinely approved items and services, and other PA requests.
• Expand beneficiary protections to improve enrollee experiences and outcomes.
• Require HHS and other agencies to report to Congress on program integrity efforts and other ways to further improve the e-PA process.

A section-by-section summary can be found here. This bill is supported by over 370 national and state organizations representing patients, physicians, MA plans, hospitals, and other key stakeholders in the health care industry. To see the list as of today, click here. Read more.

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

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

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