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

Montpelier Minute video update

Topics: Federal health care reform and budget, pharmaceutical gift ban, regulation of medical assistants, and raising the minimum age of legal access of tobacco to 21. 

Member input sought on two legislative issues
VMS is seeking member input on two pending legislative proposals: H.496 and H.345.  H.496 would require the Office of Professional Regulation to regulate the practice of medical assistants, while H.345 would expand the scope of APRNs in nursing homes, including providing “physician services.”  More » 

Multiple bills advance before “Crossover” deadline
Many legislative committees were busy making final changes and taking votes last week, as Friday was the “crossover” deadline for bills to make it out of their initial committee of jurisdiction.  VMS was active in a number of discussions around final language, including bills addressing Vermont’s vital records laws, and pharmacists and “interchangeable” biologic products.  More »    

Tobacco 21 advances to Senate floor
S.88, the bill to increase the age to possess and use tobacco products to 21, will be on the Senate Floor Wednesday.  VMS encourages you to contact your Senator and ask them to support this important public health measure. 
Marijuana legislation in flux
VMS continues to monitor H.170, a bill that in it’s current form would legalize one ounce of marijuana, growing of three mature plants and six immature plants.  Last week it seemed that this bill might have died in committee, but may be taken up again this week.  The Society will keep you updated as more information on the process becomes available. 

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.


VPR: Middlebury's Porter Medical Center Will Join The UVM Health Network

The members of Porter Medical Center voted Wednesday to affiliate with UVM Health Network. The Middlebury hospital will be re-branded as UVM Health Network–Porter Hospital.  Porter Medical Center approved the necessary bylaw changes for the affiliation to begin in April.  Dr. Fred Kniffin, Porter's CEO, says the affiliation will help stabilize the hospital’s financial situation.  More »  

VTDIGGER: Regulators set hearing on for-profit surgical center proposal
The Green Mountain Care Board has set a hearing date on the permit application to build a surgical center in Colchester that a group of independent doctors submitted nearly two years ago.  The board, which acts essentially as judges in reviewing certificate of need applications for capital investments in the health care system, has scheduled the hearing for April 13.  “I’m very excited that we now have a hearing date,” said Amy Cooper, executive director of HealthFirst, an organization for providers at physician-owned practices. The Green Mountain Surgical Center would cost $1.8 million to build. It would offer basic surgeries, such as knee repairs and hysterectomies, and other procedures such as colonoscopies and treatment for spinal pain.  Cooper said the facility would compete with local hospitals, such as the University of Vermont Medical Center, but only to provide the most basic surgeries and procedures.  More »


BECKERS HOSPITAL REVIEW: AMA launches website urging civic action against AHCA
The American Medical Association is launching an effort aimed at getting the provider community involved in healthcare reform on the Hill.  The physician association Monday rolled out an interactive website,, which provides a way for clinicians and patients to contact Congress members via email, phone and social media. The website is also intended to be a resource for updated information on healthcare reform. The website appears to be a counteraction against the American Health Care Act legislation put forth by Republicans last week. The AMA publicly denounced the AHCA, largely because it would cause a significant drop in health insurance coverage.  More »  

KAISER HEALTH NEWS: Sticker shock forces thousands of cancer patients to skip drugs, skimp on treatment
John Krahne received alarming news from his doctor last December. His brain tumors were stable, but his lung tumors had grown noticeably larger.  The doctor recommended a drug called Alecensa, which sells for more than $159,000 a year. Medicare would charge Krahne a $3,200 copay in December, then another $3,200 in January, as a new year of coverage kicked in.  For the first time since being diagnosed 10 years ago, Krahne, now 65, decided to delay filling his prescription, hoping that his cancer wouldn’t take advantage of the lapse and wreak further havoc on his body.  With new cancer drugs commonly priced at $100,000 a year or more, Krahne’s story is becoming increasingly common.  One-third of Medicare patients who were expected to use Gleevec — a lifesaving leukemia medication that costs up to $146,000 a year — failed to fill prescriptions within six months of diagnosis, according to a December study in the Journal of Clinical Oncology.  More » 

NY TIMES: Health bill would add 24 million uninsured but save $337 billion, report says
The House Republican plan to replace the Affordable Care Act would increase the number of people without health insurance by 24 million by 2026, while slicing $337 billion off federal budget deficits over that time, the nonpartisan Congressional Budget Office said Monday.  The coverage numbers released Monday will make it only more difficult for Republicans to explain why their legislation would improve the country’s health care system. And that could make the bill’s fate in the more narrowly divided Senate much more tenuous.  Average premiums for people buying insurance on their own would be 15 to 20 percent higher in 2018 and 2019 than they would be under current law, the budget office said.  More »

NY TIMES: Health policy expert is confirmed as Medicare and Medicaid Administrator
The Senate on Monday confirmed Seema Verma, a health policy expert from Indiana, to lead efforts by the Trump administration to transform Medicaid and upend the Affordable Care Act.  By a vote of 55 to 43, the Senate approved the nomination of Ms. Verma to be the administrator of the Centers for Medicare and Medicaid Services, which spends more than $1 trillion a year on programs providing health care to more than one-third of all Americans.  More »  

FORBES: Medical residents can work 24 hours straight, accreditor says
A group that accredits medical residency programs is lifting caps on work hours of first-year doctors-in-training, saying young residents aren’t harming patient care by working 24 consecutive hours plus another four to transition their patients to another provider.  The announcement Friday by the Accreditation Council for Graduate Medical Education (ACGME) makes final a set of revisions to residency professional standards. The new requirements take effect July 1 of this year.  More »  

KAISER HEALTH NEWS: By law, hospitals now must tell Medicare patients when care is ‘observation’ only
Under a new federal law, hospitals across the country must now alert Medicare patients when they are getting observation care and why they were not admitted — even if they stay in the hospital a few nights. For years, seniors often found out only when they got surprise bills for the services Medicare doesn’t cover for observation patients, including some drugs and expensive nursing home care.  More »  

STAT NEWS: Mayo Clinic: Privately insured patients to get priority over Medicaid, Medicare patients
Citing tighter profit margins, the chief executive of the Mayo Clinic recently told his employees that the prestigious health system will prioritize the care of privately insured patients over those on Medicare and Medicaid.  That bold pronouncement by Dr. John Noseworthy — made in a speech to employees late last year — reflects the growing unease among hospital executives who are watching profits shrink due to steady increases in the number of government-insured patients.  More »

MODERN HEALTHCARE: Docs left in the dark by CMS over MACRA compliance requirements
Doctors are potentially facing a loss of millions in Medicare reimbursement dollars due to lack of MACRA-related guidance from the CMS, according to a letter to the CMS from the Medical Group Management Association.  In a final rule announced last year, the CMS said it would exempt physician practices with less than $30,000 in Medicare charges or fewer than 100 unique Medicare patients per year from complying with the Merit-based Incentive Payment System outlined under MACRA.  The agency was supposed to formally notify these doctors in December of their exemptions. The threshold in the final rule would exclude 30% of physicians from complying with MIPS, according to an American Medical Association analysis.   But three months into the first year of MACRA implementation, doctors have not received the notifications. That leaves them vulnerable if they do nothing; the CMS can later tell them they're on the hook for complying with the law.  More »


2017 Council Meetings
- Saturday, April 8, 9-11 a.m., Best Western, Waterbury
- Wednesday, Sept. 13, 7-8:30 p.m., GoToMeeting or conference call
- Sunday, Nov. 5, 9-11:30 a.m., Woodstock Inn, Woodstock, VT

Stepping forward together: Advancing equity and cultural competency to improve population health
March 27-28
Burlington Sheraton
Info here.  

Pastore Financial Group Complementary Financial Planning Webinars
Mid-career physicians
April 8, 12 noon to 1 p.m. and 7:30 to 8:30 p.m.
Info here

Lyme disease and Zika in Vermont update
April 29, 8 a.m. to 1:30 p.m.
Equinox Village, Manchester Center
CME’s & CEU’s available
Info at or or (802) 885-2126, ext. 205 

Challenges to Professionalism in a Time of Change
Presented by the Maine Medical Association
June 17th, 8 a.m. to 4 p.m. 
Sheraton Hotel, Portsmouth, NH
Info here

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

2017 LUNG FORCE Expo May 9th
The American Lung Association’s second annual LUNG FORCE Expo will be held May 9 at the DoubleTree by Hilton Hotel in South Burlington.  The Expo is designed for patients, caregivers and healthcare providers to learn more about the latest trends, resources and research surrounding lung cancer, COPD and asthma.

Grow your lung health knowledge with presentations on:

  • New Methods to Motivate and Help Hard-Core Smokers Quit
  • IPF and Palliative Care
  • Insights into the Asthma - COPD Overlap Syndrome
  • Lung Cancer Screening: 2017 Update
  • Patient-and-Family Centered-Care

Register here, or for more information contact Alex Crimmin at or by phone at (802) 876-6861.

ADAP survey request
The Vermont Department of Health Division of Alcohol and Drug Abuse Programs (ADAP) is working to improve access to and the quality of adolescent substance abuse assessment, treatment and recovery services in Vermont.  It needs physicians’ input on the specific strengths, needs and concerns of their community.  Responses to this 5-110 minute survey will be anonymous, unless survey takers choose to give their name and contact information. The information gained from this Needs Assessment will be used to assess the adolescent substance abuse treatment services in local communities.. Take the survey here

CME: Breaking Through Physician Stress & Burnout to be offered April 20-22 in Maine 
Maine Medical Educational Trust and DocExecutive are offering a 3-day residential CME (47 Category 1 credits) in New Gloucester, Maine, called “Breaking Through Physician Stress & Burnout.”  The workshop is designed to provide a relaxing, stress-free environment through which the latest research for improving mental health and replacing emotionally imbalanced behaviors with healthy alternatives will be translated into personal action planning. More info at  

© Vermont Medical Society 2016
(802) 223-7898
Copyright © 2017 Vermont Medical Society, All rights reserved.

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