August 8, 2023

NEED TO KNOW

GMCB Announces Start of Statewide Hospital Transformation Community Engagement Project

Last week, the Green Mountain Care Board (GMCB) announced the start of the statewide community engagement project to support hospital transformation. Guided by the legislature’s directive in Act 167 of 2022, this project will identify community-informed opportunities to improve the sustainability of Vermont’s health care system.  As directed by the Legislature, GMCB has retained a consultant in health care system transformation, the Oliver Wyman’s Health and Life Sciences Practice,  that will be working directly with community members, businesses, hospitals, and health care organizations to ensure a wide range of voices are represented in these discussions. Community meetings are slated to begin in the fall, with initial outreach beginning this month.  Vermonters are encouraged to sign up for emails about community meetings in their region by visiting GMCB’s Hospital Sustainability webpage.  It will be very important for the consultants to hear from clinicians about patient and health system needs in your area – please consider attending.  Meetings will be a mixture of virtual and in-person to allow broad participation throughout the process. Details will be posted on GMCB’s website as they become available.

BCBSVT Confirms Changes to Modifier-25 Claim Edit Policy

After months of advocacy by VMS and other health care associations, BCBSVT has confirmed that they will be making modifications to their claims edit policy, which has delayed payment and required clinical documentation be submitted for a large number of claims submitted with Modifier -25.   According to the recent BCBSVT communication, effective August 27, 2023, 401 provider organizations (single practitioners and group practices) will have the Modifier -25 edit turned off for a year.  BCBSVT will evaluate their billing patterns and the use of the modifier every year to see if any changes need to be made.  This applies to organizations if they had fewer than 100 qualifying claims in 2022, and they have no anomalous claims, e.g. outliers, associated with the modifier.  For larger organizations where the claim edit will still apply, BCBSVT has said that they are open to explore alternate ways to obtain the records being required to justify use of the modifier and are evaluating the use of audits to exempt larger organizations with correct coding in more than 80% of claims.  VMS appreciates the progress made to-date and remains committed to working with partner organizations to address the payment delays and administrative burden that these claims edits are causing. 

2023 Shield Laws Allow Clinicians to Register for State Address Confidentiality Program

Among the protections included in Vermont's shield laws, which were passed during the 2023 legislative session, clinicians who provide reproductive health services and/or gender-affirming care are eligible to register for the State's existing address confidentiality program. Act 14 and Act 15 define reproductive health services and gender-affirming care as legally protected health care in the State of Vermont. These laws allow anyone who is providing, seeking or assisting in the obtainment of legally protected health care to participate in the address confidentiality program, which is called the "Safe at Home" program. This program provides two protective services: an address forwarding system and a protected records service. Participants are provided with the use of a generic Montpelier post office box, in which all received mail is forwarded onto the individual's actual address at no cost. The laws provide additional protections including: 

• Prevents malpractice insurance rates or coverage from changing for those that provide legally protected health care services;
• Prohibits public agencies or officials from assisting or cooperating with out of state investigations or proceedings;
• Creates a new civil penalty for using force, threat of force or physical obstruction to interfere with someone's access to legally protected health care services;
• Prohibits professional discipline solely for providing legally protected health care services or for being disciplined in another state for providing legally protected health care services.

For a comprehensive summary of all of the protections provided in Vermont's shield laws click for our 2023 VMS Final Legislative Bulletin.

Health Insurance Options for Vermonters Affected by Flooding

While communities across the state rebuild after this summer’s severe storms, the Department of Vermont Health Access is working to ensure Vermonters affected by flooding maintain their health coverage. Learn more here.

The Department of Vermont Health Access (DVHA), which administers Vermont Medicaid and Vermont Health Connect, is offering a special enrollment period for Vermonters affected by the natural disaster and in need of health insurance coverage.

Signing up for a qualified health plan is usually limited to an annual open enrollment period. However, any Vermonter who lets DVHA know that they were affected by the flood can sign up. DVHA reports over 90% of people enrolled through the health insurance marketplace qualify for financial help, with 25% of enrollees paying less than $25 a month for their health plans. Vermonters who are eligible for Medicaid can enroll at any time of year.

DVHA has also extended Medicaid for Vermonters affected by flooding. Benefits for Vermonters whose renewal deadline was in July and who didn’t respond to redetermination notices will automatically be extended into August. Vermonters affected by flooding who did respond to their renewal and no longer have any health care coverage with the State can ask for one more month of benefits. To request an extension, call 855-899-9600 by Friday, August 11.

Finally, any Vermonter enrolled in Medicaid who has been impacted by flooding should call if they have questions about their health coverage and renewal schedule. DVHA can process these renewals on the phone to ensure benefits continue.  Call DVHA toll-free at 855-899-9600 

MISC.

Connecting Refugee Health Professionals - NRC-RIM promotes sexual and reproductive health and other health topics for Afghan newcomers

The National Resource Center for Refugees, Immigrants and Migrants (NRC-RIM) collects and curates promising practices from around the country that can benefit health departments, community-based organizations and others seeking to improve their public health response. This week, they highlighted the promising practice of group prenatal care for Afghan newcomers in Washington state. Using an evidence-based model, facilitators encourage and empower pregnant participants to teach each other, which then organically ensures the conversations and curriculum are more culturally relevant.

This is the latest resource in NRC-RIM’s sexual and reproductive health collection for Afghans. A previously published Sexual and Reproductive Health Glossary includes key terms, translated from English into Dari and Pashto, that have been culturally validated and reviewed by a group of Afghan subject matter experts.

Other recent collections that support Afghan health include summer safety and lead poisoning. 

For more information, visit their website, sign up for their newsletter, and follow them on Twitter or Facebook.

Volunteer Opportunity in Honduras

Cape Cares is a nonsectarian nonprofit organization that has been sending medical-dental teams to rural Honduras for about 30 years. Volunteers (physicians, NPs, PAs, nurses) are needed for a trip from October 21-28th this fall.  The destination is San Marcos, a remote mountain village that is visited twice yearly by a Cape Cares team.  Visit Capecares.org for more information, or contact Dave Coddaire, MD, of Morrisville, the team leader for this trip: 802-798-2496, 802-888-5650 or coddaire@pshift.com.

Commissioner of Health Public Health Notes from Update and Next Call on Thursday, September 7th

The Commissioner of Health, Mark Levine, MD, joined the VMS for a public health update on August 3rd. You can find the notes here.

The next Public Health Update will be Thursday, September 7th 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.

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 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.

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.

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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