CDC Overhauls Childhood Vaccination Schedule, Reduces Number Of Recommended Shots

The Washington Post reports the Administration is “overhauling the list of routine shots recommended for all babies and children in the United States.” Effective immediately, the CDC will “no longer recommend every child receive vaccines for rotavirus, influenza, meningococcal disease, respiratory syncytial virus (RSV), hepatitis A and hepatitis B, according to materials released Monday by the Department of Health and Human Services. Instead, smaller groups of children and babies should get those vaccines only if they are at high risk or if a doctor recommends it.”

The New York Times reports the CDC’s new schedule “continues to recommend vaccines against some diseases, including measles, polio and whooping cough, for all children,” but immunization for six other illnesses “will be recommended for only some high-risk groups or after consultation with a health care provider.” The new schedule also “circumvents the detailed and methodical evidence-based process that has underpinned vaccine recommendations in the nation for decades.” Public health experts “expressed outrage at the sweeping revisions, saying federal officials did not present evidence to support the changes or incorporate input from vaccine experts.”

The AP reports that Administration officials “said the overhaul…won’t result in families who want the vaccines losing access to them, and said insurance will continue to pay. But medical experts said the decision creates confusion for parents and could increase preventable diseases.” The change also comes as US vaccination rates are declining and “the share of children with exemptions has reached an all-time high, according to federal data.”

NBC News also reports.

Read full article from American Health Law here.

Virginia’s Top Doctors 2026: Anesthesiology

The VCU Department of Anesthesiology continues to be well-represented for providing excellent anesthesia care! 14 of VCU’s faculty members have been recognized by The Virginia Business Magazine as TOP DOCS honors for 2026! Congratulations to all. 

  • Dr. Ilia Brusilovsky
  • Dr. Alice Coombs
  • Dr. Ronsard Daniel
  • Dr. Matthew Isenhower
  • Dr. Arunthevaraja Karuppiah
  • Dr. Christin Kim
  • Dr. Fatoumata Kromah
  • Dr. Aaron Lim
  • Dr. Sergio Navarrete
  • Dr. Nirvik Pal
  • Dr. Pranav Shah
  • Dr. Laura Webb
  • Dr. Andrew Chapman (Pain Management)
  • Dr. Nicolas Maxymiv (Pain Management)

2026 Medical Fee Schedules and Ground Rules Go Into Effect January 1, 2026

On January 1, 2026, the Virginia Workers’ Compensation Commission will implement the 2026 Medical Fee Schedules and Ground Rules that will establish the maximum fees for fee scheduled medical services rendered to injured workers pursuant to (a) the Virginia Workers’ Compensation Act (Title 65.2 of the Code of Virginia) during the period from January 1, 2026 through December 31, 2027; and (b) amendments to regulation 16 VAC 30-110-10 et seq. Click below to view the following information:

Additional Schedule resources available include the MFS Calculator and MFS Administrative Determination Notice. Both include:

  • Line-Level Adjustments – each claim line now clearly shows impact of Ground Rule adjustment(s) to the maximum fee.
  • Fee Calculations – are also displayed as the calculated maximum fee per code.

Tutorials for each are linked here.

Questions? Email the Medical Fee Services team here. 

Virginia Medical News 2025

The latest issue of Virginia Medical News now available!

2025 has been an outstanding year for the Medical Society of Virginia. Thanks to you, our members, we were able to:

  • Advocate for the House of Medicine at the Virginia General Assembly, including meeting with over 120 GA members during our Lobby Days
  • Expand access to mental health support for children, new mothers, and adults navigating behavioral health issues through our VMAP and APAL programs
  • Provide over 60 hours of CME to over 150 learners, along with offering CEU classes for Practice Managers across the state
  • And so much more!
Click here to read the latest issue of Virginia Medical News now!

If you’d like to read more about what the MSV has been up to, check out these issues of Virginia Medical News from previous years:

Have you renewed your membership for 2026 yet? If not, it’s easy to renew online with just a few clicks. We appreciate your continued support and look forward to another successful year!

Infant Botulism Outbreak Linked to Recalled Infant Formula


November 18, 2025

Dear Colleague:
This letter provides information on an outbreak of infant botulism linked to ByHeart powdered infant formula. At this time, there are no cases of infant botulism from Virginia included in this outbreak.

Background
The Centers for Disease Control and Prevention (CDC) and public health officials in several states, the Infant Botulism Treatment and Prevention Program, and the FDA are investigating a multistate outbreak of infant botulism linked to recalled infant formula. Epidemiologic data show that ByHeart Whole Nutrition infant formula might be contaminated with Clostridium botulinum and is making infants sick.

As of November 14, 23 infants with suspected or confirmed infant botulism have been reported from 13 states: Arizona, California (2), Illinois (2), Kentucky, Michigan, Minnesota, New Jersey, North Carolina, Oregon, Pennsylvania, Rhode Island, Texas (2), and Washington. All 23 infants were hospitalized and treated with BabyBIG® (Botulism Immune Globulin Intravenous medication). No deaths have been reported.

CDC and FDA recommend that parents and caregivers immediately stop use of all ByHeart Whole Nutrition infant formula, including cans and single serve packets. Preliminary laboratory results reported by the California Department of Public Health suggest the presence of the bacteria that produce botulinum toxin in an open can of ByHeart infant formula. On November 11, ByHeart Inc. recalled all ByHeart Whole Nutrition infant formula products. FDA does not anticipate any formula shortages as a result of this outbreak.

Infant botulism occurs when an infant ingests spores from a type of bacteria called Clostridium botulinum, which then grows in the large intestine and produces toxin that blocks the neuromuscular junction by inhibiting the release of acetylcholine. Initial signs and symptoms often include constipation, difficulty feeding (difficulty sucking or swallowing), loss of head control, weak facial expression, and reduced muscle tone. Without prompt recognition and treatment, descending paralysis may progress and involve the respiratory muscles, potentially leading to life-threatening respiratory failure. The time from ingestion to symptom presentation can be up to 30 days.

Recommendations for Clinicians
Consider infant botulism as a clinical diagnosis in any infant presenting with unexplained weakness, poor feeding, decreased head control, or difficulty swallowing — especially if the infant has consumed ByHeart formula.

When a case is suspected:

  • Immediately report all suspected cases immediately to your local health department.
  • Arrange for consultation with the Infant Botulism Treatment & Prevention Program (IBTPP) at 510-231-7600 for evaluation and treatment guidance. Consultation is available 24 hours a day, 7 days a week.
    • If clinical consultation supports infant botulism, begin treatment with BabyBIG® without delay. Do not wait for laboratory confirmation to initiate case management. Early recognition and treatment are critical.

Your local health department will discuss options for public health testing. Laboratory personnel must be alerted if botulism is suspected so they can take appropriate precautions. Botulinum toxins are extremely poisonous and exposure to the toxin is the primary laboratory hazard.


Recommendations for Institutions, Hospitals, and Clinical Laboratories

  • Do not use or distribute any of the recalled ByHeart Whole Nutrition infant formula. Remove it from inventory and inform relevant staff.
  • Clean and sanitize feeding areas and equipment that may have been exposed.
  • Infant botulism is an immediately reportable condition. It is important to quickly reach out to VDH when a case is suspected to coordinate on timely collection of clinical specimens and processes for confirmatory testing.
  • Participate in trace-back efforts, leftover product collection, and laboratory testing as requested by state health departments, CDC, and FDA.

Resources

Thank you for your partnership in keeping Virginians safe and healthy.

Sincerely,

Karen Shelton, MD

State Health Commissioner

Costs are rising and doctors are leaving | RTD Commentary by Dr. Joel Bundy

DR. JOEL BUNDY

October 28, 2025

Our nation’s health care system is under stress. Sadly, Virginia is not immune to the rising costs and strained health care workforce the rest of America is facing. The commonwealth ranks in the bottom half of states for physician availability, and by 2030, Virginia is projected to be short by nearly 4,000 doctors. This problem was exacerbated during the COVID-19 pandemic, which spurred physician burnout and resulted in critical staffin shortages.

This is making it challenging for Virginians to obtain primary care appointments, a particularly large concern for those who suffer from chronic disease or have complex health needs. In a state that is 88% rural, Virginians who live outside major cities are at serious risk. With fewer doctors available, patients often must wait longer for care and paymore out of pocket — costs that many simply can’t afford. Rural residents depend on community-based practices for their health care needs. These patients, many of whom live in under-resourced areas, are going to suffer the most if this trend continues.

Physician shortages are being amplified by shrinking Medicare payments. Even when adjusted for inflation, Medicare physician reimbursement has declined 33% since 2001, placing independent physicians in a dangerous position. Without reimbursement that keeps up with inflation, physicians are increasingly unable to expand their services, hire new staff, or take on new Medicare patients. This would put thousands of patients in Virginia at risk of losing access to local, timely, and affordable care.

Unable to keep up with the growing gap between reimbursement and rising costs, some doctors are even choosing to leave the Medicare program altogether. Primary care physicians have been exiting traditional Medicare at the highest rates, with 4.41% departing in 2023. Small practices, the pillars of Virginia’s rural communities, are especially vulnerable to the forces pushing physicians to exit.

The U.S., in short, needs long-term Medicare payment reform before it is too late. The latest Medicare Physician Fee Schedule (MPFS) proposed rule is a positive step in the right direction. Following a directive from Congress, Centers for Medicare and Medicaid Services (CMS) proposed a small increase in physician reimbursement next year.

During a recent hearing, our very own Rep. Morgan Griffith, of Virginia’s 9th District and chairman of the House Energy and Commerce Subcommittee on Health, said he wants to bolster the health care workforce and improve health care in rural communities. As a physician leader, I could not agree more. We encourage Congressman Griffith and all members on Congress to support long-term Medicare payment reform, so our physicians and our patients don’t have to suffer.

It’s time for Congress to pass long-term Medicare payment reform that ties annual reimbursement rates to inflation. From wages and rent to medical supplies and equipment, the cost of running a medical practice continues to rise. Yet Medicare payments to physicians have not kept pace. This mismatch threatens the viability of independent practices — especially here in Virginia — and could limit access to care for millions of Americans.

Dr. Joel Bundy was president of the Medical Society of Virginia 2024-2025.

Read article on Richmond-Times Dispatch here or on the Daily Progress here.

The MSV Installs President Mark Townsend, MD as President at 2025 Annual Meeting

RICHMOND, Va. (Oct. 27, 2025) – Mark Townsend, MD, of Richmond, Virginia, was installed as the president of the Medical Society of Virginia (MSV) during the organization’s Annual Meeting held on October 25, 2025, in Norfolk. Dr. Townsend currently serves as a physician leader at Bon Secours, where he has been a driving force in advancing patient-centered care and medical technology across his organization.

In his inaugural address, Dr. Townsend spoke of his calling to advocate as a physician: “Are each of us doing ALL that we can to advocate for those who are most vulnerable among us? I believe that I am called to advocate for the vulnerable.  My life experiences have prepared me to advocate for those who are the most vulnerable, the least of these our brethren.”

Dr. Townsend’s presidential agenda will focus on enhancing physician engagement, addressing workforce challenges, and promoting innovative solutions to improve healthcare delivery. He is committed to fostering collaboration among healthcare professionals, policymakers, and community leaders to ensure Virginia remains a leading state for both practicing medicine and receiving care.

Dr. Townsend is a graduate of the Virginia Military Institute (VMI) where he received a Bachelor of Science in biology and a Bachelor of Arts in modern languages. He spent 13 years at Virginia Commonwealth University (VCU) where he trained and served as an Associate Professor of Internal Medicine and Pediatrics.

A respected clinician and advocate, Dr. Townsend brings a wealth of experience and a collaborative spirit to his new role. His leadership will be guided by MSV’s mission to support Virginia physicians in delivering high-quality care and improving the health of all Virginians.

About the Medical Society of Virginia

The Medical Society of Virginia (MSV) serves as the voice for more than 30,000 physicians, residents, medical students, PAs and PA students, representing all medical specialties in all regions of the Commonwealth. The association was founded in 1820 and is headquartered in Richmond, Virginia. MSV strives to advance high-quality healthcare and make Virginia the best place to practice medicine and receive care.

The Medical Society of Virginia Foundation Recognizes Seven Outstanding Physicians

Richmond, Va. (Oct. 27, 2025) –The Medical Society of Virginia (MSV) Foundation announced the winners of their annual Salute to Service Awards at their Physicians Gala on Saturday, October 25, 2025. Seven Virginia physicians are being recognized from across the Commonwealth for their outstanding service in six categories: Service to — the Profession, the Uninsured and Underinsured, by an Early Career Physician, a Medical Student or Resident Advancing Patient Safety and Quality Improvement, and Distinguished Medical School Faculty Service Award.

The premiere award, Service to the Profession, has been given to Dr. Sterling N. Ransone, Jr., MD former president of the Medical Society of Virginia and the American Academy of Family Physicians.

The 2025 Winners of the MSV Foundation’s Salute to Service Awards include:

  • Kaitlin Hardy, MD, Resident PGY1, Department of Pediatrics; Macon & Joan Brock Virginia Health Sciences, EVMS at Old Dominion University, Service by a Medical Student or Resident
  • Megan Powers, MD, Emergency Medicine Residency; Macon & Joan Brock Virginia Health Sciences, EVMS at Old Dominion University, Service by a Medical Student or Resident
  • Dimal D. Shah, MD of Richmond, Service by an Early Career Physician
  • Laurie Archbald-Pannone of Charlottesville, Service for Advancing Patient Safety and Quality Improvement
  • Joshua Easter, MD, MBA, MSc, MHA, of University of Virginia, Service by a Distinguished Medical School Faculty Member
  • David E. Rapp, MD of Glen Allen, Service to the Uninsured and Underserved
  • Sterling N. Ransone Jr., MD of Deltaville, Service to the Profession

The MSV Foundation created the annual Salute to Service Awards in 2004 to recognize outstanding efforts of physicians, residents, and medical students who are dedicated to creating and nurturing a caring health promotion and disease prevention environment by providing service on behalf of patients everywhere.

About the Medical Society of Virginia Foundation

The MSV Foundation (MSVF) advances opportunities for physicians to participate in health improvement efforts in Virginia by supporting programs and initiatives that equip physicians to best serve themselves, their patients and their communities. For more information, visit www.msv.org/foundation.

Virginia Credit Union, Member One Partner with State Trade Group to Sponsor Financial Education and Counseling for Medical Professionals Beginning Their Careers

Virginia Credit Union and its Member One division are sponsoring a series of webinars and workshops across Virginia that will provide financial education and free financial counseling to support medical students and doctors starting their careers.

“No matter where we are on our financial journeys, one thing is true: We would all benefit from the knowledge and skills necessary to make informed financial decisions, because we’ll all face challenges,” said VACU’s Cherry Dale, Senior Vice President of Financial Education. “For many medical students and new doctors, the cost of medical school and the often substantial debt that follows are only part of the equation. There are numerous other financial hurdles, including the expense of training, limited earning potential early in their careers, and difficulty saving for retirement due to debt burdens. Through our sponsorship of the Medical Society of Virginia’s Thrive program, we’ll help provide future and current medical professionals with the education they’ll need to meet their financial challenges head-on.”

The Medical Society of Virginia’s (MSV) Thrive program offers five on-site, in-person workshops and five webinars, each designed to help medical students and professionals better navigate their financial futures.

Read more here.

Now Available: 2026 MIPS Payment Adjustment Information


The Centers for Medicare & Medicare Services (CMS) has released Merit-based Incentive Payment System (MIPS) payment adjustment information for the 2024 performance period/2026 MIPS payment year.

Your 2024 MIPS final score determines the MIPS payment adjustment you’ll receive in 2026. A positive, negative, or neutral payment adjustment will be applied to the Medicare paid amount for covered professional services furnished in 2026.

Access Your MIPS Payment Adjustment

  • Sign in to the Quality Payment Program (QPP) website using the same credentials that allowed you to submit your 2024 MIPS data and check your 2024 MIPS final score. Refer to the QPP Access User Guide (ZIP, 4MB) for more information.
  • Click “View Feedback” on the home page and select your organization (Practice, Alternative Payment Model (APM) Entity, Virtual Group).
    • Practice representatives can access individual, subgroup, and group performance feedback (final scores and payment adjustments).
    • APM Entity representatives can access APM Entity-level performance feedback (final scores and payment adjustments).
    • Virtual group representatives can access virtual group-level performance feedback (final scores and payment adjustments).
    • Third party representatives can’t access final feedback or payment adjustment information.
    • If you don’t have a HARP account or QPP role, please refer to the Register for a HARP Account (re: HARP account) and Connect to an Organization (re: QPP role) documents in the QPP Access User Guide (ZIP, 4MB) and start the process now.

Medicare Shared Savings Program Accountable Care Organizations (ACOs)

Medicare Shared Savings Program ACOs are encouraged to identify at least one individual within your ACO who can obtain a HARP account with the Security Official role; additional individuals may request the Staff User role. ACO individuals can create and manage their HARP account and QPP access in the ACO Management System (ACO-MS).

Contact your ACO to find out how you can obtain a HARP account via ACO-MS. If you have any questions, please contact the ACO Information Center at [email protected] or 1-888-734-6433 (Option 1).

  • REMINDER: Representatives of Shared Savings Program ACO Participant Taxpayer Identification Numbers (TINs) and practices with clinicians receiving their APM Entity’s final score won’t be able to access the APM Entity’s performance feedback unless they’ve been granted the “staff user” QPP role for the APM Entity.

Payment Adjustment and Performance Feedback Resources:

2024 Targeted Review Request Period Open Until November 14, 2025[1]

Beginning with the 2024 performance period/2026 MIPS payment year, the targeted review period closes 30 days following the release of MIPS payment adjustments (refer to 42 CFR 414.1385(a)(2)).

Who Can Request a Targeted Review?

Individual clinicians, groups, subgroups, virtual groups, APM Entities (including Shared Savings Program ACOs), designated support staff and authorized third party intermediaries may request that CMS review their MIPS final score and MIPS payment adjustment factor through a process called targeted review.

When to Request a Targeted Review

Review your MIPS performance feedback, including your MIPS final score and payment adjustment factor(s), on the Quality Payment Program website. If you believe there’s an error in the calculation of your MIPS final score or MIPS payment adjustment factor, you can request a targeted review now until November 14, 2025, at 8 p.m. ET. Be advised that our ability to respond to inquiries and resolve requests will be delayed in most cases until normal government operations resume.

Examples of circumstances that could prompt a Targeted Review:

  • Data were submitted under the wrong TIN or National Provider Identifier (NPI).
  • You have Qualifying APM Participant (QP) status and shouldn’t receive a MIPS payment adjustment.
  • Performance categories weren’t automatically reweighted even though you qualify for reweighting due to extreme and uncontrollable circumstances.

Note: This isn’t a comprehensive list of circumstances.

How to Request a Targeted Review

To access your MIPS final score, performance feedback and request a targeted review:

  • Sign in using your HARP credentials (ACO-MS credentials for Shared Savings Program ACOs); these are the same credentials that allowed you to submit your 2024 MIPS data and check your 2024 final score.
  • Click “Targeted Review” on the left-hand navigation.

CMS may require documentation to support a targeted review request, which varies by circumstance. A CMS representative will contact you about providing any specific documentation required.

  • 2024 Targeted Review User Guide (PDF, 2MB) – Reviews the process for requesting a targeted review and examples for when you would or wouldn’t request a targeted review. (We’re in the process of updating this resource with the Targeted Review deadline.)

[1] Note: The federal government shutdown doesn’t affect your ability to submit a targeted review request by the above deadline, however it may affect our response time to resolve your request.