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Click Here to Complete
the Common Claims Survey
This survey was prepared by the
Vermont Medical Society and MBA HealthGroup. It was designed to inform a
multi-stakeholder legislative
study group that is studying edit standards and
transparency in order
to make a recommendation to the Vermont legislature
before January
of 2011. Responses will be compiled by the Vermont Medical
Society
and reported to the study group.
For questions please contact Madeleine Mongan at
mmongan@vtmd.org or Colleen Magne at
cmagne@vtmd.org - or by telephone at
802-223-7898.
Advocacy
The Vermont
Medical Society is the only organization advocating full-time on behalf of
Vermont’s physicians. The VMS represents the interests of more than 1,800
physicians, residents, and medical students before the state and federal
governments. The issues that the VMS advocates on include:
_
Federal Advocacy
Due to the SGR, the
2006 Medicare Trustees report forecasts cumulative cuts in the Medicare
physician payment update of 37 percent by 2015.
VMS is working with
other physician groups to repeal the forecasted 4.6 percent cut in Medicare
physician payments in 2007.
VMS
staff is providing direct input on the AMA’s strategy to repeal the SGR formula,
based on past policy experience in drafting for Senator Jeffords the first
legislation to address the SGR formula (S.1660, 2001).
Geographic Practice
Cost Indices (GPCI) Reform
VMS is working for the reauthorization of the
current 1.0 floor in the GPCI work component of RBRVS that expires December 31,
2006. The 1.0 work floor has resulted in a 2.8 percent increase in Medicare
reimbursement for Vermont physicians (in 2004, Vermont’s work GPCI was 0.973).
VMS staff has been asked by Geographic Equity in Medicare Coalition to be one of
two individuals representing the coalition nationally in this effort.
Federal Medical Liability Reform
VMS has repeatedly advocated that Vermont’s Congressional delegation support the
passage of federal medical liability reform, including a $250,000 cap on
non-economic damages
State Advocacy
Act 191 Catamount
Health Plan
In testimony before legislative committees, and in meetings with Senate
leadership and consumer groups, VMS successfully argued against using “hospital
charity care” as a funding source for Catamount Health. VMS also advocated that
Catamount Health be available only through private insurers in order to avoid it
becoming a further expansion of the Medicaid program.
The VMS has been named as a member of the
executive committee for the “Blueprint for Health” -- the state’s plan for
chronic care infrastructure, prevention of chronic conditions, and chronic care
management program. The plan will include methods for identifying patients,
processes for coordinating care, and payment methodologies creating financial
incentives to improve disease management.
VMS also serves on a common claims and
procedures work group that will make recommendations for simplifying the claims
administration process.
Workers’ Compensation
Medical Fee Schedule
The VMS is currently working for the
implementation of a new workers’ compensation fee schedule that will increase
physician reimbursement from the current average of 126 percent of Medicare to a
new average rate of 160 percent of Medicare. Payments for physicians under
Vermont’s workers’ compensation medical fee schedule have not increased since
1995.
Medicaid reimbursement
VMS was successful in
helping to obtain a $5 million increase in Medicaid reimbursement for physicians
to begin addressing the adverse impacts of low Medicaid reimbursement on access
and the cost shift. Beginning on January 1, 2007, the legislation provides for
an increase in base rates for evaluation and management procedure codes to a
level equivalent to the 2006 rates in the Medicare program and funding an
increase in base rates for current procedural terminology codes which are
significantly lower than the 2006 Medicare reimbursement levels starting with
the lowest first.
State Medical
Liability Reform
In the 2006 session, the VMS
was successful in having a bill introduced in the Vermont General Assembly that
would establish pre-trial screening panels, expert witness standards, and a
$250,000 limit on non-economic damages. The bill was supported by Governor Jim
Douglas.
Prescribers
Monitoring Program
The VMS worked with Vermont Department of Health and the Vermont Department of
Public Safety to secure passage of a bill authorizing the Vermont Department of
Health to create a prescription monitoring program for controlled substances on
Schedules II, III and IV. The VMS achieved its primary objective of ensuring
that the database has a health focus and that law enforcement will only have
access to prescribing data after clinical review. The VMS will serve on the
advisory committee for implementation of the monitoring program.
Medical Error Reporting
The VMS has worked with the
Vermont Association of Hospitals and Health Systems and the Vermont Department
of Health to develop a comprehensive patient safety surveillance and improvement
system for the purpose of improving patient safety, eliminating adverse events
in Vermont hospitals, and supporting and facilitating quality improvement
efforts by hospitals. The provisions require four different levels of internal
and external reporting by hospitals of adverse health events. Each level
of reporting relies on a tailored definition of what will be reported that is
consistent with the uses appropriate to the organization or individuals
receiving the information.
Safe Apology
The VMS
worked to secure passage in 2006 of a “safe apology” statute in Vermont in order
to encourage greater communication between physicians and their patients about
possible medical errors without fear of the discussion being used against the
physician in a future civil proceeding. The VMS defeated legislation
mandating
written notification by
physicians to any patient affected by an adverse health care event. In the
legislation, an “adverse health care event”
was very broadly defined as an “untoward incident, a therapeutic misadventure,
or an iatrogenic injury.”
Optometry Formulary
The VMS successfully advocated
to retain in law a formulary requirement for optometrists that the Office of
Professional Regulation in the Secretary of State’s office proposed to repeal;
the repeal would have permitted optometrists to prescribe any oral drug.
Emergency Preparedness
The VMS
worked with the Vermont Association of Hospitals and Health Systems and the
Vermont Department of Health to ensure that medical volunteers would have access
to workers’ compensation coverage, liability protection and malpractice
protection in the event of an all-hazards emergency.
Death with Dignity/Physician Assisted Suicide
The VMS presented to
legislators during the 2006 session the Society’s position against laws
concerning Physician Assisted Suicide that was developed by the membership and
VMS Council in 2003. After additional discussion and debate the bill failed to
pass out of the committee on a party line vote of five to five.
Vermont Pay for
Performance
VMS staff co-chairs the
Blueprint For Health (Governor’s Chronic Care Initiative) Health Systems
Subcommittee. The subcommittee is charged with recommending metrics for
performance improvement and making recommendations on pay for quality programs.
Drug
Utilization Review (DUR) Board
VMS staff works with the DUR
Board and Office of Vermont Health Access to minimize the administrative burden
on physicians of the state’s preferred drug list (PDL).
Vermont Information Technology Leaders (VITL)
VMS staff is on the board of
VITL, a multi-stakeholder organization that has developed a strategy for sharing
data between hospitals and physicians. VMS staff also serves as co-chair of the
subcommittee on financing.
Fluoridation
VMS staff, in collaboration
with the Vermont State Dental Society and the Chittenden County Medical Society,
created a successful media campaign to defeat efforts to repeal fluoridation of
water supplies in Burlington and Montpelier. The VMS also worked on a separate
campaign which successfully defeated a ballot item to end fluoridation in
Bellows Falls.
Tobacco Cessation
VMS staff serves on the
Executive Committee and the Policy Committee of the Coalition for a Tobacco Free
Vermont. The VMS worked to fund Catamount Health in part through an increase in
the cigarette tax. The VMS is also active in promoting tobacco cessation efforts
in Vermont.
Go to the Top
To read
specific VMS resolutions and policies, click here
For
information on how to become a VMS member and support these and other advocacy
efforts, click here |
