Several changes to health care policy passed by the Vermont legislature have either gone into effect this summer or will soon. Key changes that could impact physician practices include new rules on opiate prescribing and related CME requirements, physician acquisitions and transfers, increased Medicaid reimbursement for primary care services, improved health insurance coverage for contraceptives and new DNR and COLST processes.
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Act 173 passed by the legislature this spring directed the Vermont Department of Health (VDH) to craft rules regarding prescribing opioids for acute pain, consider new VPMS query requirements for prescribers, consider co-prescribing of naloxone in certain circumstances and to require informed consent to patients prescribed opioid medication. The Commissioner of Health was directed to convene and consult with a newly-created Controlled Substances and Pain Management Advisory Council in drafting the rules.
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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 and clarifications of existing requirements.
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In a 3-2 decision released in May, the Vermont Supreme Court created a new duty for mental health professionals to warn caregivers about the risks of a patient’s dangerous behavior and to provide the caregivers with particular information about how to care for the patient.
While the case has been remanded to the Superior Court for further factual development and a request for rehearing by the Supreme Court is still pending, the new “duty to inform” standard is the current law applied. The Vermont Medical Society has recently entered a joint defense agreement with the attorneys representing several of the facilities involved in the case and can share with interested members a document providing practical legal guidance on how psychiatrists, emergency physicians and others involved in treating those with mental illness can begin to implement the decision.
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The license renewal process for physicians for the next biennium (Dec. 1, 2016 to Nov. 30, 2018) will begin August 30, 2016 and will close Wednesday, Nov. 30, 2016. The Vermont Board of Medical Practice recommends that physicians complete their renewals before Nov. 10, 2016 to ensure that their renewal application is reviewed before Nov. 30, 2016.
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