July 18, 2023


Vermont and VMS Flood Response – Clinician Volunteers Needed for Montpelier First Aid Tent


Vermont and VMS continue to recover from historic flooding. VTDigger recently covered the destruction at the Johnson Health Center. Lamoille Health Partners is assisting with temporary space and VMS will share more information about how to support their recovery efforts as it becomes available. Please continue to reach out to us if there are ways we can assist your practice or your patients. 


In Montpelier, home to VMS, nearly all downtown businesses, government offices and non-profits have been impacted. Within a few blocks of VMS, the offices of many of our partner organizations were also flooded, including Vermont Program for Quality in Health Care, the Vermont Association of Hospitals and Health Systems, the Vermont Ethics Network, the VNAs of Vermont, and the Green Mountain Care Board. VMS staff is busy addressing the water damage in our building, which will require the removal of part of the walls and insulation and all of the flooring and cabinets on our first floor. Our electrical and heating systems were also damaged. We are fortunate to have excellent contractors step up to work with us on these projects, though VMS staff – with some help from friends, family members and Devon Green of VAHHS - got to immediate work on removing wet furniture, carpet and cabinets. 


If you are looking for ways to assist in the recovery efforts, there is an urgent need for clinicians to volunteer at the Central Vermont Medical Center first aid tent supporting downtown Montpelier through this Friday, July 21st. This is a critical part of our efforts to provide medical care and support to those in need. This is basic first aid (minor wound treatment, eye washes, heat related illness treatment, providing public health guidance on safety / masking/ PPE) so any health care background is welcome. To view available shifts or sign up, please visit volunteersignup.org/FPTBJ. CVMC is also in the process of planning a first aid tent in Barre.


Montpelier Alive has also set up a page dedicated to volunteering (for non-clinical skills), donating and seeking assistance for those located in the Montpelier area here.  The City of Barre has a volunteer sign up here. The State of Vermont has also created a volunteer registry.  If you are able to donate money, the Vermont Community Foundation has launched a Flood Response and Recovery Fund


For other resources in responding to the flooding visit: 

For any practice or businesses impacted by the flood, the U.S. Small Business Association (SBA) is opening SBA Business Recovery Centers in Washington and Windsor Counties and to begin offering disaster assistance in the form of low-interest loans. Register at disasterloanassistance.sba.gov/ela/s/ or call 1-800-659-2955 to learn more. 

This Week: Blueprint for Health Community Health Team Expansion Q&A

As a reminder, webinars happening this week will answer practice questions about the expanded funding for the Blueprint for Health Community Health Teams to implement a two-year pilot program designed to improve access to mental health and substance use disorder services through increased integration with primary care.

The remaining webinars this week are scheduled for:

The webinar slides are available here. To read more about the proposed expansion, click here for a summary and here for implementation planning documents.  

Reminder: Vermont Medicaid Covers All Clinically Appropriate Services via Audio-Only When Due to Unforeseen Circumstances

As recently published, Vermont Medicaid continues to allow audio-only (telephone) services for a defined list of codes beyond the end of the COVID-19 public health emergency. 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 consider coverage of audio-only services that are not on the approved list when unforeseen circumstances necessitate a service to be delivered audio-only.   As recently confirmed by DVHA, providers needing to provide services via audio-only beyond the defined list submit the claim as normal, and DVHA will engage in post payment review.  If there is an evident pattern beyond expected use of audio-only, DVHA would likely ask for clinical documentation to justify that audio-only was used for unforeseen circumstances.  Given the recent natural disaster impacting patients’ ability to travel to medical appointments, there is expected increased use in audio only.   Practices who need more information or have questions should contact their Gainwell provider representative at (800) 925-1706.

Feedback Sought on Timeline for Prior Authorization Approvals

The Vermont Medical Society is in conversation with the Department of Financial Regulation and Green Mountain Care Board regarding legislation to address the prior authorization process.  One proposal under discussion for the 2024 legislative session includes to decrease the timeframe for health insurers to respond to completed PA requests for urgent PAs to 24 hours, as currently required by at least 10 states.  Vermont law currently sets maximum response timelines at 48 hours for urgent and 2 business days for non-urgent requests. 18 V.S.A. §9418b (g)(4).  Please share feedback regarding this proposal with Jessa Barnard at jbarnard@vtmd.org.   It would be helpful to hear:  are there instances of urgent PA requests currently taking longer than 24 hours; any patient stories regarding the impact of waiting longer than 24 hours for a PA approval; or any other feedback regarding the utility of this proposal. 

AMA Analysis of the 2024 Medicare Physician Payment Schedule

Last week, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule for the calendar year (CY) 2024 Medicare Physician Payment Schedule. While the American Medical Association (AMA) staff analyze and develop a summary of the nearly 2,000-page rule, we want to make you aware of a handful of key provisions.  

The 2024 Medicare conversion factor is proposed to be reduced by 3.36 percent from $33.8872 to $32.7476. The CMS Press Release states the decrease is 3.34 percent, but we believe this is an error. Similarly, the anesthesia conversion factor is proposed to be reduced from $21.1249 to $20.4370. These cuts result from a reduction in the temporary update to the conversion factor under current law and a negative budget neutrality adjustment stemming in large part from the adoption of an office visit add-on code, discussed below. Unfortunately, these cuts coincide with ongoing growth in the cost to practice medicine as CMS projects the increase in the Medicare Economic Index (MEI) for 2024 will be 4.5 percent. Physician practices cannot continue to absorb these increasing costs while their payment rates dwindle. This is why the AMA and our partners in organized medicine strongly support H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which would provide a permanent, annual update equal to the increase in the MEI and allow physicians to invest in their practices and implement new strategies to provide high-value care. Visit the AMA’s Fix Medicare Now site and join the fight for financial stability for physician practices to preserve access to care for Medicare beneficiaries.  Read the full AMA summary and links to further information here.

Cannabis Control Board Seeking Medical Professionals for Study of the Medical Cannabis Registry

As part of this year's cannabis legislation, Act 65, the Cannabis Control Board (CCB) is seeking interested parties, including medical professionals, to participate in a work group charged with evaluating Vermont's medical cannabis registry and to develop legislative recommendations to modernize and improve the cannabis registry. 

The review is required to include:

  1. an assessment of the illnesses or symptoms most appropriately treated by cannabis;
  2. the strains of cannabis recommended for such treatment;
  3. the doses of active chemicals recommended for treatment;
  4. appropriate treatment protocols for patients, including whether ongoing medical oversight such as counseling or other services is needed for each condition being treated;
  5. how the use of cannabis is communicated to patients and patients’ providers; and
  6. any other issues that will improve the Registry.

This committee is authorized to meet at least 4 times over the next 5 months. These meetings will be held in person at the Montpelier office of the CCB and there will also be an option to join remotely. Please jsudhoffguerin@vtmd.org if you are interested in participating.

Meet Vermont’s New Medicaid Director on July 27th from 12:15 to 1pm – VMS Members Invited to an Open Discussion 

VMS Members are invited to a Zoom meeting with the Vermont Agency of Human Services new State Medicaid Director, Monica Ogelby. Each state has a Medicaid Director to oversee Medicaid and CHIP programs. This position oversees not only the Medicaid health care program administered by the Department of Vermont Health Access but elements of Medicaid that are administered by other Departments such as Aging and Disabilities and Corrections. Ms. Ogelby will be joined on the call by Pat Jones, Interim Director of Health Care Reform at the Agency of Human Services and Kristin McClure, Health Care Reform Integration Manager at AHS.  Ms. Obelby most recently served as the Vermont Department of Health Immunization Program Director. The call will give VMS members an opportunity to hear updates on AHS projects and to ask questions regarding Vermont’s Medicaid programs. 

Join us on July 27th from 12:15 to 1pm here.


GMCB Hosts Virtual Public Comment Forum for Health Insurance Premium Review on July 24

On July 24, the Green Mountain Care Board (GMCB) is hosting a virtual public comment forum for health insurance premium review. Members of the public are encouraged to attend this virtual event or submit written public comment on or before July 24 via the GMCB website.  

GMCB Virtual Public Comment Forum: July 24 from 4:30-5:30 pm 

Call-in number: (802) 828-7667 Conference ID number: 739 467 433# 

Click here to join the Microsoft Teams meeting

Each summer, Vermont health insurance companies submit requests to GMCB for approval of their proposed small and individual health plan insurance rates. This year, Blue Cross Blue Shield of Vermont (BCBSVT) and MVP Health Care (MVP) have submitted proposed premiums (also known as rates) for their 2024 small group and individual health plans. These rates impact the over 68,000 Vermonters who purchase individual or small group health insurance on Vermont’s health insurance exchange – Vermont Health Connect – or directly from BCBSVT or MVP. These rates do not impact other types of health insurance, such as Medicaid, Medicare, or self-funded employer plans. The rate increases being proposed are driven by a number of factors, including increases in hospital and prescription drug costs.

The public comment deadline for small group and individual premium requests is July 24 to ensure GMCB can consider comments prior to issuing decisions on August 7. 

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 by August 25th 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.

VDH Division of Substance Use Releases Stimulant Use Data Brief and Response Initiatives

The Vermont Department of Health Division of Substance Use (DSU) has released the most recent Stimulant Misuse in Vermont data brief, which provides a comprehensive overview of stimulant misuse in Vermont. This brief shows a general increase in stimulant misuse over the last few years, including increases in: 

  • Hospital visits related to stimulant misuse;
  • Diagnoses of stimulant use disorder; and
  • Fatal overdoses that involved stimulants.

The DSU has also released the Opioid and Stimulant Response Initiatives to provide details of Vermont’s response to the increase in opioid and stimulant misuse. This work reportedly will be enhanced by the strategies funded by H.222 (Act 22), which the VMS reported on during the 2023 session. You can find this information and more on the DSU Data and Reports webpage and their Stimulants webpage.

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.

Commissioner of Health Public Health Update on Thursday, August 3rd

The next Public Health Update call with Commissioner of Health Mark Levine, MD will be Thursday, August 3rd 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 join the zoom meetings here.



Vermont Medicaid Top 10 Claim Denial Reason Webinar

July 26, 2023, 11am to 11:45am

Gainwell Technologies will be providing a webinar to review the top 10 claim denial reasons for Vermont Medicaid CMS 1500 Physician claims. In this webinar, we will discuss the 10 denial reasons, where to find them on your remittance advice, what the definition of the denials are and how to correct the denial if applicable.

Space is limited, so be sure to register as soon as possible here.

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

Wilderness Medicine Conference

October 15 – 17, 2023

Delta Hotel in South Burlington, Vermont

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.

CPT & RBRVS 2024 Annual Symposium

November 15-17, 2023

CPT & RBRVS 2024 Annual Symposium is the world's only medical coding conference where attendees learn about the upcoming changes to the Current Procedural Terminology (CPT) code set and payment policies directly from members of the AMA-convened CPT Editorial Panel, AMA/Specialty Society Relative Value Scale Update Committee (RUC), and CPT and RUC Advisors.

Join virtually to get the first look at the 2024 CPT code set with guidance from the experts, earn continuing education credits, and join over a thousand of your peers for premier coding education at the CPT & RBRVS Symposium!

Register with early bird discounted rates through September 30th here.

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


Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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