A Capehart Scatchard Blog

Telemedicine Essentially Missing from MACRA MIPS Final Rule

By on October 19, 2016 in Medicare with 0 Comments

The final rule on MACRA’s Merit-Based Incentive Payment System (MIPS), the new Medicare payment model, scheduled to take effect on January 1, 2017, made a significant change to the 2015 proposed rule in that it largely eliminated quality scoring for telemedicine and remote monitoring services to Medicare beneficiaries from MIPS.  MIPS will be the quality based payment model under which most physicians will operate.  Telemedicine services are included in some of the alternate payment models set forth under the final rule, such as next generation ACOs and the Comprehensive Primary Care Plus model.

While quality metrics for use of electronic medical records remain in MIPS in terms of supporting the exchange of patient information, many practitioners and private payors feel that MIPS should include telehealth activities as telemedicine can reduce costs of patient monitoring and improve patient access to care. But Medicare is very limited in how it can reimburse for telemedicine services. The lack of telemedicine quality measures in MIPS may spur adoption of federal legislation to expand Medicare’s telehealth payment policy.

Stay tuned. CMS will receive public comments on the final rule for 60 days.

For more information on telemedicine, including the risks and benefits for practitioners, please attend our “Hot Topics in Healthcare Law” 2016 Breakfast Series entitled “Expand Your Practice While Staying Within the Lines.”


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Sheila Mints

About the Author

About the Author:

Ms. Mints specializes in healthcare transactional matters, including shareholder and employment agreements, purchases and sales of medical practices, including ACO transactions, and practice mergers. Ms. Mints acts as general counsel to many large practices and ambulatory care facilities, assisting with transactional, tax, human resources mattes and negotiation with payors and vendors. An experienced tax lawyer, Ms. Mints represents her clients before the Internal Revenue Service, the federal Tax Court and state taxation departments in a variety of tax matters.


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