Medicaid Reimbursements

During the 2009 legislative session, VMS voiced aggressive opposition to a nine-percent cut in physician Medicaid reimbursement rates proposed by Gov. James Douglas. Despite a severe budget shortfall and rapidly declining revenue forecasts, the Vermont General Assembly was unwilling to go along with the governor's proposal, instead passing legislation limiting the cut to two percent.

Marketing of Prescribed Products

VMS supported the passage of S. 48, which revised the previous pharmaceutical disclosure law by banning many gifts outright and mandating full disclosure of allowable expenditures to physicians, health care organizations, state-funded academic institutions, and non-profit groups. VMS also took a lead role in the last minute addition of language that deleted the disclosure of free drug samples from the bill.

Pain and Palliative Care

Responding the concerns of its members, VMS successfully advocated against the passage of a bill that would have required all physicians licensed by the Vermont Board of Medical Practice to complete a minimum of four hours of palliative CME every two years.

Contract Standards

VMS successfully advocated passage of legislation that contained numerous provisions favorable to physicians, including reducing the time for both health insurers and workers' compensation carriers to pay claims, establishing contract standards for health plan contracts with physicians and regulating rental networks.

Colorectal Cancer Screening Insurance Mandate

With the passage of VMS-supported H. 24, health insurers in Vermont are now required to cover colorectal cancer screenings. The screenings must be in accordance with American Cancer Society guidelines and patients cannot be charged co-payments of more than $100.

Tobacco Use in the Workplace

The General Assembly passed legislation that further restricted the use of lighted tobacco products in most workplaces. The bill closed loopholes in the existing Smoking in Public Places Law (Clean Indoor Air Act). VMS supported this legislation.

Disclosure of Patient Information to Medical Examiner

Under a bill spurred by the Department of Health and supported by VMS, health care providers will now be required to provide the medical records of deceased patients to the state's chief medical examiner when requested.

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.

VMS is 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 includes 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 makes recommendations for simplifying the claims administration process.

Workers' Compensation Medical Fee Schedule

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

In 2006, 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 Jan. 1, 2007, the legislation provided 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 funded 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

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

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. 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. VMS staff serve on the advisory committee for implementation of the monitoring program.

Medical Error Reporting

VMS 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

VMS worked to secure passage of a "safe apology" statute in Vermont that encourages 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. 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

VMS successfully advocated retaining 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

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

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.

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).

Health Information Technology

VMS staff is on the board of Vermont Information Technology Leaders (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 that 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. VMS worked to fund Catamount Health in part through an increase in the cigarette tax. VMS is also active in promoting tobacco cessation efforts in Vermont.