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NEED TO KNOW
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Insurance Rate Public Comment Forum this Thursday 4-5pm
The Green Mountain Care Board is in the midst of holding insurance rate review hearings for MVP and Blue Cross and Blue Shield of Vermont. In May, the Green Mountain Care Board received the 2026 individual and small group health insurance premium rate filings from the plans. The initial filings requested increases of 23.3% (BCBSVT individual market); 13.7% (BCBSVT small group market); 6.2% (MVP individual market); and 7.5% (MVP small group market). These rates are impacted by a variety of factors, including the end of enhanced federal tax credits leading to healthier customers dropping coverage due to high cost and customers with more health needs staying in the insurance pool.
The remaining hearing dates and times are below. Materials and a link to submit written public comment can be found here.
Wednesday, July 23 – QHP Rate Review Hearings – BCBS (8 am to 5 pm)
Teams Meeting Link
Call-In Information: +1 802-828-7667 CODE: 567890424#
Thursday, July 24 - QHP Rate Review Hearings – BCBS continuation (9 am to 12 pm)
Teams Meeting Link
Call-in Information: +1 802-828-7667 CODE: 855686031#
Thursday, July 24 – Rate Review Public Comment Forum (4 pm to 5 pm)
Teams Meeting Link
Call-in Information: +1 802-828-7667 CODE: 335616820# |
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2026 Proposed Medicare Physician Fee Schedule Includes Downward Adjustments for Facility-Based Physicians
As covered in the Rounds last week, CMS recently released the proposed 2026 Medicare Physician Fee Schedule. According to an analysis by Medpage Today, the fee schedule update varies depending on whether physicians are participating in an alternative payment model (APM). Physicians who do participate in a qualifying APM will receive an increase of $1.24, or 3.83% in the conversion factor used as a multiplier to calculate what Medicare will pay for physician services. Physicians who don't participate in an APM will receive an increase of $1.17, or 3.62%. These adjustments take into account a 1-year increase of 2.5% passed by Congress in the recent reconciliation bill.
According to the AMA, absent the temporary 2.5% increase due to the reconciliation bill, there are two new and controversial proposals in the rule that would cut most specialties and facility-based (hospital and ambulatory surgical center) practices while increasing payment to some office-based practices. The impacts relate to the efficiency adjustment and the practice expense adjustment
The rule includes a 2.5% decrease to the work RVUs and physician intra-service time of most services in the fee schedule on the assumption that physicians have gained efficiency in providing them. The decrease would be applied to 8,961 physician services. CMS also proposes an arbitrary reduction in indirect practice expense RVUs for all services provided in the facility setting. An analysis of expected changes in fee schedule by specialty can be found here. See the AMA explanation of these changes here.
A more detailed AMA summary of the rule will be available soon. The rule is now in a 60-day comment period, which ends on September 12, 2025. Reach out to Jessa Barnard at jbarnard@vtmd.org with any feedback to incorporate into comments. |
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VMS Resource Page - Immigration Enforcement in Health Care Settings
With reports of the Centers for Medicare and Medicaid Services releasing Medicaid enrollee information to Immigration and Customs Enforcement, as well as continued detentions of immigrants within Vermont, VMS reminds our members that we have resources on our website to help health care facilities be prepared to respond if immigration enforcement agents come to speak to patients, staff or the public. See our resources here. |
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Registration Open for 2025 Collaborative Meeting The 212th VMS Annual and Collaborative Meeting will be held on November 7th and 8th in-person with the option to join virtually for the Awards Ceremony. 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. Topics include: - Battling Misinformation
- AI Uses in Local Practices
- Medical Student and Resident Case Presentations
- Beyond Moral Injury - Reclaiming Agency, Belief, & Joy in Medicine
- Health Reform Panel Presentations with Discussions
Register today! |
MISC.
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Larner College of Medicine Literary and Visual Arts Magazine Seeks Submissions
UVM Larner College of Medicine’s literary and visual arts magazine, The Red Wheelbarrow, is looking for submissions in the literary and visual arts! We particularly welcome work in the medical humanities, an interdisciplinary field that aims to make sense of medical practice, education, and human health and disease; non-medical work is also welcomed. The literary arts include prose, poetry, reporting, and personal essays. The visual arts include photography, painting, graphic design, drawing, and 3-D art (e.g., sculpture, ceramics, fiber). For 3-D submissions, please provide a picture of your work. Submissions can be submitted to the following link: https://tinyurl.com/2p9spta6 The deadline for submissions is August 1st, 2025 at 11:59 PM. Please reach out to redwheelbarrowuvm@gmail.com if you have any questions! |
EVENTS
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For more information about offerings from UVM
CMIE, visit here. |
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Vermont Medical Society 134 Main Street Montpelier, VT 05602 -- Unsubscribe -- |
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