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

Reminder: New non-discrimination requirements apply to health care practices
On May 18, the US Department of Health and Human Services (HHS) issued a Final Rule implementing a prohibition of discrimination by health care services found in Section 1557 of the Affordable Care Act (ACA).  Section 1557 builds on long-standing Federal civil rights laws that have already applied to most health care practices. While many of the provisions of the Final Rule are not new to physicians, there are several new procedural requirements – such as adopting grievance procedures and posting notices of non-discrimination – and clarifications of existing requirements.   For more information about the requirements, including sample policies and notices, translated materials and interpreter resources, see the full summary on the VMS Website.

VHCIP offering webinar on privacy and security of sharing clinical information
In cooperation with the Vermont Health Care Innovation Project, Lucia Savage, Chief Privacy Officer with the federal Office of the National Coordinator for Health Information Technology, will provide a webinar for Vermont exploring HIPAA-appropriate options for data aggregation and sharing of information across organizations.  The webinar will take place Dec. 16, from 1 to 2 p.m. Click here to join or for more information.


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: Scott picks Gobeille as Secretary of Human Services

Gov.-elect Phil Scott will appoint the chair of the Green Mountain Care Board to lead Vermont’s Agency of Human Services, the largest in state government. Gobeille, 52, has served on the Green Mountain Care Board since it was established in 2011 and became chair in August 2013. He has worked closely with Gov. Peter Shumlin’s administration to negotiate the all-payer model.  Gobeille’s term on the board is not scheduled to end until Sept. 30, 2018, but he will start the new position in the first week of January, when Scott is inaugurated. The new governor will need to appoint Gobeille’s replacement. More »

VTDIGGER: State sets limits on initial painkiller prescriptions
Vermont will limit how many opioid painkillers doctors can prescribe to patients and require them to counsel patients on the risks of addiction before prescribing.  A legislative committee has finished the rulemaking process on the bill Gov. Peter Shumlin signed into law to prevent overprescribing. The law will go into effect July 1.  Under the new rules, doctors and other prescribing clinicians will be allowed to prescribe no more than seven days’ worth of opioid painkillers at a time for adult patients who don’t take them on a regular basis.  Much as they do today, pharmacists will be able to reach out to doctors to discuss the dosage prescribed for a specific patient. The Board of Medical Practice will be able to take complaints of overprescribing from patients or others and investigate doctors who break the rules. More » 

VTDIGGER: Chen won’t seek reappointment as Health Chief
Dr. Harry Chen will not seek to be reappointed as commissioner of the Vermont Department of Health.  Chen told his staff in an email Tuesday that he decided over the Thanksgiving holiday not to apply to continue under Gov.-elect Phil Scott’s new administration.  Chen has served in his current position since 2011, when Gov. Peter Shumlin took office. More » 

VTDIGGER: Dartmouth-Hitchcock chief executive to retire in June
The president and chief executive officer of Dartmouth-Hitchcock Medical Center and the Dartmouth-Hitchcock Health system will retire June 30.  Dr. James Weinstein, 66, has been with the hospital system since 1996 and has held his current role since 2011. He told the board of trustees in 2015 that he would be leaving the post, according to a press release. More » 

SEVEN DAYS: Court Case Could Clarify Doctors’ Obligations in End-of-Life Law  
Are Vermont doctors obligated to tell their terminally ill patients that they can request a prescription to hasten their own deaths? That question is at the core of a federal court case.  Three-plus years after a Vermont end-of-life law went into effect, the legal challenge unfolding in Rutland could decide how involved medical professionals have to be in informing patients of the law. More » 


NY TIMES: U.S. Health Spending in 2015 Averaged Nearly $10,000 Per Person
Total spending on health care in the United States increased last year at the fastest rate since the 2008 recession, reaching $3.2 trillion, or an average of nearly $10,000 a person, the Department of Health and Human Services reported on Friday.  The growth coincided with continuing increases in the number of Americans with insurance coverage, through private health plans or Medicaid.  Federal spending on health care has increased by 21 percent over the past two years, as millions of Americans gained coverage through the Affordable Care Act, the department said in its annual report on health spending. More »  

NY TIMES: Immune system, unleashed by cancer therapies, can attack organs
As Chuck Peal lay in a Waterbury, Conn., emergency room one Sunday in early September, doctors furiously tried to make sense of his symptoms. Mr. Peal, 61, appeared to be dying, and they were not sure why.  In the seven weeks prior, doctors at Yale had combated Mr. Peal’s melanoma with two of the most promising drugs in cancer treatment today. These medicines work by stimulating the immune system to attack cancer as ferociously as it does other threats, like viruses and bacteria.  These so-called immunotherapy drugs have been hailed as a breakthrough in cancer treatment, attracting billions of research dollars and offering new hope to patients out of options. But as their use grows, doctors are finding that they pose serious risks that stem from the very thing that makes them effective. More »  

BOSTON GLOBE: Depression common among medical school students, study finds
When he attended medical school in Texas, Dr. Douglas Mata saw the problem all around him. Many students either knew a classmate who was depressed or had been there personally.  This experience in part prompted Mata to coauthor the largest analysis yet on the prevalence of depression in medical school, showing that it afflicts 27 percent of students. Eleven percent of students were found to have suicidal thoughts. More »  

NY TIMES: Sweeping Health Measure, Backed by Obama, Passes Senate
The Senate approved complex health care legislation on Wednesday that would increase funding for disease research, address weaknesses in the nation’s mental health systems and vastly alter the regulatory system for drugs and medical devices. The vote sealed a final legislative victory for President Obama, who strongly supported the bill against objections from many liberal Democrats and consumer groups. More »   

WASHINGTON POST: U.S. life expectancy declines for the first time since 1993  
For the first time in more than two decades, life expectancy for Americans declined last year — a troubling development linked to a panoply of worsening health problems in the United States.  Rising fatalities from heart disease and stroke, diabetes, drug overdoses, accidents and other conditions caused the lower life expectancy revealed in a report released Thursday by the National Center for Health Statistics. In all, death rates rose for eight of the top 10 leading causes of death. More »  

WASHINGTON POST: Surgeon general calls youth e-cigarette smoking ‘a major public health concern.’  
The surgeon general on Thursday called the skyrocketing use of e-cigarettes among youth “a major public health concern,” saying that while more research needs to be done on its potential harms, policymakers should take strong action to keep the products out of the hands of the nation's young people.  E-cigarettes are now the most commonly used form of tobacco among young people in the United States, having surpassed conventional cigarettes in 2014. More »  

NPR: Doctors and hospitals tell patients: Show us the money before treatment
At many doctors offices and hospitals, a routine part of doing business these days is estimating patients' out-of-pocket payments and trying to collect the money up front.  Approximately three-quarters of health care and hospital systems ask for payment at the time services are provided, a practice known as "point-of-service collections." More »  

POLITICO: AMA members ask AMA to clarify position on Tom Price
The American Medical Association's unqualified endorsement of Price's nomination to be HHS Secretary didn't sit well with some members last week, who said they'd leave the organization and spread the hashtag #NotMyAMA on social media. Now, they're making the case more formally through an open letter.  "We are disappointed by our AMA's enthusiastic endorsement," reads the letter signed by more than 370 American Medical Association members - including more than 90 delegates and alternate delegates. They argue Price's desire to strike down Obamacare coverage expansion, change how Medicare and Medicaid are structured and defund Planned Parenthood are in direct opposition to the AMA's own goals for access and care. Price also has questioned the need for LGBTQ-related protections. "We ask that our AMA release an additional statement as soon as possible clarifying AMA policy positions," the letter-writers urge. More » 
WASHINGTON POST: Trump takes aim at drug companies: ‘I don’t like what has happened with drug prices’
Biotech and pharmaceutical stocks rose after the election, reflecting investor optimism that a Trump presidency would mean less focus on drug prices. Not so fast, president-elect Trump said in his interview for Time 'Person of the Year.'  “I’m going to bring down drug prices,” Trump told Time in an interview in his dining room after the election. “I don’t like what has happened with drug prices.”
No additional detail about what Trump would do to lower drug prices was available, and his transition team did not immediately respond to requests for more information. But Adam Fein, president of Pembroke Consulting, a firm focused on pharmaceutical economics, said that what Trump may be doing is sending a signal to the industry. More » 

VHCIP Webinar
Dec. 16
1 to 2 p.m.
Privacy and security of sharing clinical information
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. 

MMS CME courses available 
VMS members are eligible to register for Massachusetts Medical Society CME courses.  If you have any questions about the registration or the login process, please contact the MMS Continuing Education Department at (800) 322-2303, ext 7306, or via email at

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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