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MACRA and Telehealth Updates

The following is an update from the Florida Medical Association regarding MACRA:

On Friday, October 14, CMS released the final implementing rule for the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). While the final rule does not halt the implementation of the Merit-Based Incentive Payment System (MIPS) or adopt all of the recommendations that the FMA and other medical societies fought for, it does provide for changes that will make it much easier for physicians to participate in CMS’ Quality Payment Program (QPP).


Provided is a high-level summary of two of the most substantial changes announced in the final rule:


The low-volume threshold has been greatly increased, thereby exempting more physicians from MIPS. Under the final rule, eligible clinicians or groups who do not exceed $30,000 of billed Medicare Part B allowed charges or 100 Part B-enrolled Medicare beneficiaries will be excluded from MIPS. CMS notes that the same low-volume threshold will apply to both individual MIPS eligible clinicians and groups because groups have the option to elect to report at an individual or group level.


This change will come as welcome news to many small practices. The previous threshold, which was set at $10,000 in allowed charges and 100 or fewer patients, was absurdly inadequate by any standard. The revised threshold, while still less than ideal, is a substantial improvement.


The reporting requirements needed to avoid penalties have been drastically reduced. Reporting even a single quality measure or improvement activity will be enough to avoid a penalty in the first year of MIPS. Reporting additional data can lead to potential bonuses.


More information on the changes included in the final rule, and what those changes will mean for physicians, will be published in this weeks’ FMA News. Stay tuned.


From the Desk of DCMS Chief Executive Officer, Bryan Campbell:

Tuesday morning, doctors, legislators and health care providers from around the state gathered at Nemours Childrens Specialty Care in Jacksonville to contemplate the future of the delivery of healthcare in Florida.

The Telehealth Advisory Council was created during the legislative session back in March to review and help guide the state in implementing telehealth in Florida. The Council will meet several times before reporting back to the Legislature and Governor Scott suggestions about the best ways to move forward.

Sen. Travis Cummings  of Jacksonville helped to author the legislation and was on hand to introduce the esteemed panel, which includes Florida Surgeon General, Dr. Celeste Philip and Board of Medicine Chair and Mayo physician, Dr. Sarvam Terkonda. 

Discussion ranged from high level topics as appropriate reimbursement models and patient outcomes, to more seemingly simple but deceptively complex topics such as deciding how to define telehealth. A half dozen different definitions of telehealth were discussed and none was agreed upon by the Council. 

Justin Senior is the Interim Secretary for the Agency of Health Care Administration and Chair of this Council. He informed the group that transportation is the single largest logistical hurdle for Medicaid in the state at this time, and that telehealth can help to bring affordable access to the Medicaid patient population. 

Members of the community were allowed to present comments at the meeting, including words from Ronald "Doc" Renuart, D.O., former State Representative and President-elect of the Florida Osteopathic Medical Association. 

Almost every participant showed enthusiasm for the potential of better patient care with telehealth, but as one member stated "Remember that one person's cost-savings is another person's income reduction." There is no doubt that reimbursement models will take center stage as the Council continues to meet.

If you would like to participate in the Council meetings, or share your experience with telehealth, you will have many opportunities to do so. The Council will meet again on November 17th in Safety Harbor. All are welcome to attend. If you are unable to attend in person but would like to submit comments, you can submit them via email by clicking here.

To learn more about the Telehealth Advisory Council, visit the Council webpage.




Rep. Travis Cummings speaks on Telehealth. 

Rep. Travis Cummings speaks on Telehealth.