June 27, 2023

NEED TO KNOW

Please note that there will be no Rounds Weekly Newsletter
on July 4, 2023 due to the holiday.

2023 Session Ends With Veto Override on $8.5 billion Budget

Lawmakers left the Statehouse on May 12th in the middle of a divisive disagreement over whether to extend the COVID-19 motel voucher program, which, along with the Governor's anticipated veto, put a hard-fought agreement on the FY24 Budget in question. As the June veto session neared, tension on all sides was high, and there were questions of whether the Democrats would have the votes to override the Governor’s budget veto, or if they would have to craft a new budget bill before July 1st, 2023 - the start of the State's fiscal year.

Thankfully legislators and the Scott Administration came to an agreement on a supplementary bill providing transition dollars for unhoused Vermonters and the Vermont House and Senate quickly overrode the Governor's veto on the $8.5 billion FY24 Budget. Not only does this budget contain historic funding levels for housing, higher education, substance use and mental health, it also includes significant Medicaid rate increases, including bringing Medicaid rates for primary care services to 110% of Medicare rates and an inflationary increase for specialty services. The jam-packed 2023 legislative session ended somewhat abruptly on Tuesday, June 20th, after legislators also overrode Governor Scott's vetoes on 5 other bills, and the veto session scheduled for three days was over in one. 

VMS had a busy and successful legislative session, accomplishing not only needed Medicaid rate increases, but shield laws for clinicians who provide reproductive and gender-affirming health care services, firearm safety, opioid use disorder treatment, workplace violence protections and more. The VMS policy team has prepared the 2023 VMS Final Legislative Bulletin, which provides summaries and the status of the legislation that VMS actively tracked this session, grouped into seven categories:

• COVID-19 Emergency
• Health Financing/Health Reform
• Mental Health
• Practice of Medicine
• Insurance Regulation
• Professional Regulation / Scope of Practice
• Public Health

Click here for the 2023 Legislative Bulletin. 

VMS Board Meets this Wednesday for Priority Planning

The Vermont Medical Society Board will be holding an in-person planning retreat this Wednesday, June 28^th to review accomplishments from the past year and prioritize objectives for 2023-2034.  The Board will begin by reviewing the results from the 2023 member survey, 2023 priorities and the status of 2023 priorities, available here. The Board will also have a guest speaker, hearing an update on Green Mountain Care Board activities and opportunities for clinician input from GMCB Chair, Owen Foster.  To share feedback regarding 2023-2024 VMS priorities, reach out to President Ryan Sexton, MD at president@vtmd.org.

THURSDAY: Join Sen Sanders, Sen. Welch, and Rep. Balint for a Town Meeting on the Youth Mental Health Crisis

Senators Sanders, Welch and Rep. Balint will be holding a town meeting this Thursday on the mental health crisis our young people are facing. The public is invited to share your stories and hear from experts about how we can work together to address the needs of our young people and their families: Thursday, June 29 at 7:00 P.M. at Spaulding High School in Barre. RSVP here.  On Tuesday afternoon, Senator Sanders also held a press conference to announce and discuss the expansion of North Star Health – the Federally Qualified Health Center in Springfield – into the Brattleboro community.  Learn more here.

Vermont Medicaid Continued Telehealth/Audio-Only Coverage; Expanded Dental, Family Planning Coverage

The Vermont Medicaid program has published its proposed plan for continuing to allow audio-only (telephone) services for a defined list of codes now that the COVID-19 public health emergency has ended.   The list of codes mirrors the Medicare allowance for audio-only codes and includes additional codes that are clinically appropriate and align with correct coding guidelines. Vermont Medicaid will also consider coverage of audio-only services that are not on the approved list when unforeseen circumstances necessitate a service to be delivered audio-only.  More information will be released prior to July 1 regarding how to use the unforeseen circumstances coverage. The codes will be reimbursed at parity to in-person visits.   This policy will be effective July 1, 2023. 

These flexibilities will continue through December 31, 2024. Over the next 18 months, DVHA will review the services delivered via telehealth and encourages Medicaid providers and stakeholders to work with Vermont Medicaid on this review.  VMS and other health care organizations have been meeting with DVHA regularly over the past few months to provide input on their plans for continued coverage of audio-only services and appreciates DVHA’s partnership on this work.   For questions or concerns contact Jessa Barnard at jbarnard@vtmd.org.

With the start of the new state fiscal year on July 1, DVHA has also announced other coverage changes and expansions beginning July 1, including:

• Expanding Medicaid dental benefits by increasing the cap on expenditures per person, increasing reimbursement rates, and more;
• Increasing the limit for outpatient psychotherapy from 24 sessions per calendar year to 260 sessions per calendar year; see the Vermont Medicaid General Billing and Forms Manual Section 5.3.46.2 Psychotherapy,
• Creating a new Vermont Medicaid eligibility group that covers family planning and family planning related services; read more here;
• Providing educational resources regarding coding and billing for health visits for children and youth entering foster care; see resources here.

Locally Acquired Malaria Cases Identified in the United States

The Centers for Disease Control and Prevention (CDC) has issued a Health Alert Network (HAN) Health Advisory to share information and notify clinicians, public health authorities, and the public about the identification of locally acquired malaria cases in two U.S. states within the last 2 months, a concerns for a potential rise in imported malaria cases, and the need to plan for rapid access to IV artesunate, which is the first-line treatment for severe malaria in the United States. Learn more here.

Guidance on Measles during the Summer Travel Season

As the summer travel season begins, the Centers for Disease Control and Prevention (CDC) has issued a Health Alert Network (HAN) Health Advisory to remind clinicians and public health officials to provide guidance for measles prevention to international travelers and to be on alert for cases of measles.  Guidance is also provided for people planning international travel. To prevent measles infection and spread from importation, all U.S. residents should be up to date on their MMR vaccinations, especially prior to international travel regardless of the destination. Learn more here

MISC.

AHRQ Safety Program for Telemedicine: Improving the Diagnostic Process

Is your practice interested in improving the cancer diagnostic process in the telemedicine and hybrid environments? AHRQ is recruiting practices for a free 12-month program to improve diagnostic verification, timeliness, and communication with patients. Practices will receive training and one-on-one expert coaching to implement sustainable improvements to close the loop at critical points in the cancer diagnostic process, which has the potential to prevent harm associated with missed or delayed diagnoses. Participants will also be eligible for CEUs, CMEs, and ABIM MOC points. Learn more and sign up for an informational webinar on the program website: safetyprogram4telemedicine.org.

New Fix Medicare Now Website from the AMA

Did you know that physicians are the only providers whose Medicare payments do not automatically receive an annual inflationary update and as a result, Medicare physician payments have lagged 26% behind the rate of inflation growth since 2001?  Get all the information and resources you need to make your voice heard in the halls of Congress at the AMA’s new Fix Medicare Now website. Ensure Congress works to address the critical issues physicians and their patients face due to the flawed Medicare physician payment system.

Learn more from the AMA Advocacy Update.

Free State Park Passes for Your Patients

In our 10th Year for this program, the Vermont Governor’s Council on Physical Fitness and Sports and the Vermont Department of Forests, Parks, and Recreation proudly offer free day use State Park Passes for your patients.

The prescriptions are distributed to physician offices. The purpose is to give physicians and their colleagues a meaningful way to discuss with their patients the importance of outdoor exercise and the obvious connection between exercise and good health. This year we hope to reach as many diverse groups as we can. 

If you have questions or if you are interested in participating this year, please let us know at dbutsch@gmail.com. Please let us know how many prescription pads of 50 each you think you will be able to use when you reach out and if you are interested in posters that we may be able to send you.

The prescriptions are numbered and we hope to be able to tell which of your prescriptions were turned in at a State Park if you ask in the fall.

Mildred Reardon Medical Student Scholarship Open for Applications

Do you dream of becoming a Vermont doctor?  See below to apply for a $10,000 scholarship for a rising 3rd year student committed to practicing medicine in Vermont.

The Vermont Medical Society’s Education and Research Foundation (VMSERF) is now accepting applications for the Mildred Reardon scholarship, which awards $10,000 to a University of Vermont Larner College of Medicine third year student committed to practicing medicine in Vermont. The scholarship is made to a student interested in any specialty, with a preference for specialties in high need in Vermont.  The scholarship is tuition-linked and is paid directly to the College of Medicine towards tuition. This year the award will be made at the VMS Annual Meeting, being held at Topnotch in Stowe and virtually on November 3, 2023.  Click here for more information and details on applying for the scholarship.

Commissioner of Health Public Health Update on Thursday, July 6th

The next Public Health Update call with Commissioner of Health Mark Levine, MD will be Thursday, July 6th at 12:30 pm. Hear about the the most pressing public health information affecting the state and nation and have the opportunity to submit questions to Dr. Levine who will answer them, time-permitting. You can view the notes from the June 1, 2023 call here.

You can join the zoom meetings here.

EVENTS

Save the Date: Vermont ACP Chapter Annual Scientific Meeting

September 29, 2023 at Trapp Family Lodge, Stowe, VT

The Vermont ACP Chapter's Annual Scientific Meeting will occur on Friday, September 29, 2023. We are planning for an in person meeting. We will again host a poster competition for resident and student members.

Update your medical knowledge, engage with colleagues, and receive 5 AMA PRA Category 1 CME credits and 5 MOC points.

Meeting details, agenda and registration information will be forthcoming.

Primary Care Sports Medicine and

The 2023 Primary Care Sports Medicine and Wilderness Medicine is designed to update knowledge and skills in the diagnosis and management of common sports medicine and wilderness medicine problems. Topics will include discussions of medical and orthopedic issues. There will be ample opportunity for participants to ask questions and interact with faculty, who hail from the University of Vermont Health Network and local community. The teaching program includes lectures and workshops.

For more information, go to the website here.

Save the Date: 210th Annual and Collaborative Meeting Taking Place from November 3-4, 2023

The 210th VMS Annual Meeting will be held on November 3rd and 4th in person at Topnotch Resort, Stowe, VT, with virtual options. 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 nominate 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.

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

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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