Vermont Medical Society - Rounds Newsletter
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Everything Vermont's physicians need to know this week

UPDATE: DEA reverses changes to renewal applications 
The DEA has reversed its decision and posted a notice that it is retaining its current policy and procedures, with one minor change, regarding registration renewals.  The revised announcement states the following: Starting January 2017, DEA will no longer send its second renewal notification by mail.  Instead, an electronic reminder to renew will be sent to the email address associated with the DEA registration. At this time, DEA will otherwise retain its current policy and procedures with respect to renewal and reinstatement of registration. More »

Earned Sick Leave Notice Must Be Posted by Jan. 1, 2017
Vermont’s Earned Sick Time law takes effect on January 1, 2017.  The Vermont Department of Labor recently published its Earned Sick Time Act – Notice of Employee Rights poster.  A copy of the poster may be obtained here.  The Vermont Department of Labor has also published its answers to frequently asked questions about the law, available here.  On or before January 1, 2017, all employers with operations in Vermont should:

  • Post the Earned Sick Time Notice at your business in a place conspicuous to employees.
  • Adopt a compliant Earned Sick Time policy or ensure your existing paid time off policy (vacation, CTO, ETO or otherwise) complies with the law.
  • Provide a copy of any new or revised policy to existing employees, and provide a copy of the policy to all new hires thereafter.

VMS thanks Alexandra Clauss, Esq., of Primmer Piper Eggleston & Cramer, for sharing this update.  She can be reached at

In The News is a concise digest of health care news in Vermont and the nation.  VMS is not responsible for the content of the articles.


VTDIGGER: Report: Vermont Health Connect flawed, but state’s best option

An analysis of the state’s health insurance exchange concludes that although the system has “significant deficiencies,” the best course for the state is to stick with it.  The 121-page report by Massachusetts-based Strategic Solutions Group, commissioned by the Legislature in the budget bill, was released Wednesday.  Several issues plague Vermont Health Connect, the analysis found — including incorrect data, problems with data exchanges, lack of automation and poor customer service. The review explored alternatives to the current model, including using the federal exchange, finding a commercial option or looking to technology from another state.  “After reexamining six possible alternative solutions, the most feasible and cost-effective path for long-term sustainability is to continue to enhance the current VHC system,” the report concludes. More » 

VTDIGGER: New appointments include Tebbetts for agriculture, insurance lobbyist for health role
Gov.-elect Phil Scott picked the news director at WCAX-TV as his agriculture secretary Wednesday and chose a leader in the public safety sector to direct the Agency of Transportation. Scott also announced the appointment of Cory Gustafson, a Statehouse lobbyist for Blue Cross Blue Shield of Vermont, as commissioner the Department of Vermont Health Access. It oversees the management of Vermont’s publicly funded health insurance programs, including Medicaid, and the state’s health care exchange, Vermont Health Connect. More » 


NY TIMES: Price Transparency Is Nice. Just Don’t Expect It to Cut Health Costs
Health care prices vary tremendously. And there is no established relationship with quality.  That’s changing. Over half of the states have passed laws that either establish websites with health care prices or require plans, doctors and hospitals to disclose them to patients. But improved transparency isn’t working as well as hoped. Health care pricing apps and websites don’t always help patients spend less.  That’s the conclusion from a study published this year in The Journal of the American Medical Association. More »

NY TIMES: Pregnancy Alters Size and Structure of Brain, New Study Shows
Pregnancy changes a woman’s brain, altering the size and structure of areas involved in perceiving the feelings and perspectives of others, according to a first-of-its-kind study published on Monday.  Most of these changes remained two years after giving birth, at least into the babies’ toddler years. And the more pronounced the brain changes, the higher mothers scored on a measure of emotional attachment to their babies. More » 

WASHINGTON POST: Pregnant women are increasingly using marijuana for morning sickness, study finds. That’s not good  
More U.S. women are using marijuana during pregnancy than in previous years to treat nausea and morning sickness, a new study suggests.  According to the study published Monday in the Journal of the American Medical Association, nearly 4 percent of pregnant women between the ages of 18 and 44 reported in 2014 they had used marijuana in the past month, compared with 2.4 percent in 2002. More » 

Kaiser Health News: Women Doctors May Be Better For Patients’ Health
When a patient goes to the best hospital, he or she usually hopes for a doctor who is knowledgeable and experienced. Something else to wish for? A woman physician.  That’s because female doctors may on average be better than their male counterparts at treating patients in the hospital and keeping them healthy long-term, according to findings published Monday in JAMA Internal Medicine. More » 

WASHINGTON POST: Opioid drugs make pain tolerable, most long-term users say
At the center of the nation’s opioid crisis is a simple fact: Large numbers of Americans experience serious pain, and the vast majority of those who have used strong painkillers for a long period say they work. More » 

MODERN HEALTHCARE: Medicare sticks with mandatory bundled-pay demo, but Tom Price likely to intervene
The CMS is moving forward with a new mandatory initiative that would make hospitals in 98 markets financially accountable for the cost and quality of all care associated with bypass surgery and heart attacks.  The CMS said in the regulations that the mandatory component of the bundled-payment initiatives was necessary “to generate statistically reliable estimates of the impact as well as to be able to understand how well the models operate in a variety of circumstances.” In the final rule, the CMS also expanded its first mandatory bundled-payment model—which took effect in January and covers total hip and knee replacements—to include surgeries repairing hip and femur fractures. More »  

NY TIMES: Should Medicare Allow Outpatient Knee Replacement? Doctors Are Deeply Split  
Medicare, which spends several billions of dollars a year on knee replacements for its beneficiaries — generally Americans 65 and older — is contemplating whether it will help pay for knee replacement surgery outside the hospital, in either free-standing surgery centers or outpatient facilities.  The issue is sowing deep discord in the medical world, and the debate is as much about money as medicine. More » 

STAT: Deep divisions threaten the clout of the nation’s largest doctors group  
Who represents doctors in this unsettling environment? Decades ago, the answer would have been clear: the American Medical Association, the nation’s oldest and largest medical organization.
The AMA still has more clout — and spends far more on lobbying — than the scores of medical specialty societies and splinter groups that sort doctors by political leanings. But it counts fewer than 25 percent of practicing physicians as members, down from 75 percent in the 1950s.  And the association infuriated many doctors recently with its quick endorsement of President-elect Donald Trump’s choice for secretary of health and human services — Representative Tom Price, an orthopedic surgeon-turned-congressman who’s led the charge to overturn Obamacare. Just two weeks earlier, the AMA’s House of Delegates had reaffirmed the association’s support for coverage expansions under Obamacare. More »  

KAISER HEALTH NEWS: New Medicare Rules Should Help ‘High Need’ Patients Get Better Treatment
Doctors have complained for years that they’re not paid adequately for time-consuming work associated with managing care for seriously ill older patients: consulting with other specialists, talking to families and caregivers, interacting with pharmacists and more.  That will change on Jan. 1, as a new set of Medicare regulations go into effect.  Under the new rules, physicians will be compensated for legwork involved in working in teams — including nurses, social workers and psychiatrists — to improve care for seniors with illnesses such as diabetes, heart failure and hypertension. More » 

KAISER HEALTH NEWS: Latest Hospital Injury Penalties Include Crackdown On Antibiotic Resistant Germs
The federal government has cut payments to 769 hospitals with high rates of patient injuries, for the first time counting the spread of antibiotic-resistant germs in assessing penalties.  The punishments come in the third year of Medicare penalties for hospitals with patients most frequently suffering from potentially avoidable complications, including various types of infections, blood clots, bed sores and falls. More » 

Wednesday Webinar
Jan. 18th
12 noon to 1 p.m.
Update on the Quality Payment Program: What you need to know to be successful
More »

Running on Empty?
Jan. 25
12 noon to 1 p.m.
MMS course: Physicians' path to enjoying life and medicine
More »

2017 Annual Meeting
November 3-4, 2017
Woodstock Inn
Woodstock, Vt. 

Physician Compare undergoes update and redesign
As part of its work to make health care quality information more transparent and understandable for consumers, the Centers for Medicare & Medicaid Services (CMS) recently announced that it is adding new quality data and other information to the Physician Compare website. More » 

Sign up for the new CMS Quality Payment Program listserv
The listserv will provide news and updates on new resources and website updates, upcoming milestones and deadlines, and CMS trainings and webinars. More »

Vermont Practitioner Health Program is available to help
Are you or one of your colleague’s struggling with substance abuse issues? The VMS-administered Vermont Practitioner Health Program (VPHP) can help.  Click here for more information, or if you’d like to have VPHP present at a local staff meeting.

New England QIN-QIO launches new MACRA website
Do you need help navigating CMS’ quality payment program? Click here for help. Tools and info include a readiness assessment, the MIPS calculator, help desk, webinars and more. 

© Vermont Medical Society 2016
(802) 223-7898
Copyright © 2016 Vermont Medical Society, All rights reserved.

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