It's official: Another SGR patch, another ICD-10 delay

The Senate voted to approve a bill that will delay the implementation of ICD until at least Oct. 1, 2015. The bill now moves to President Obama, who is expected to sign it into law. The bill was passed 64-35 on Monday, March 31.

The so-called "doc-fix" bill also suspends Medicare's sustainable growth rate (SGR) formula that would have cut the physician reimbursement rate this year by nearly 24 percent. March 31 was the deadline for Congress to pass the legislation that averts the payment cut and further delays Medicare cuts to physicians until April 1, 2015. 

A seven-line section of the bill relates to the ICD-10 delay and the Senate conducted a straight “up or down” roll call vote on the bill, which prevented senators from removing any sections of the bill. Previously, in a March 27 voice vote, the House of Representatives approved the fast-track legislation that was based on a bipartisan deal struck between Senate Majority Leader Harry Reid and House Speaker John Boehner. 

In an opening statement to begin the Senate's consideration of the bill, Reid acknowledged that the 12-month temporary SGR fix in the bill "is not perfect, not ideal" but it "ensures that Medicare patients will be able to see their doctors." The legislation is Congress’ 17th temporary Medicare patch since 1997. Sen. Ron Wyden (D-Ore.), recently named chairman of the Senate Finance Committee, tried but failed to get the Senate to consider a permanent Medicare SGR fix during debate on the bill.

The American Health Information Management Association (AHIMA) said its officials will work to clarify outstanding questions raised by the delay and continue to work with government officials to implement ICD-10.

“On behalf of our more than 72,000 members who have prepared for ICD-10 in good faith, AHIMA will seek immediate clarification on a number of technical issues such as the exact length of the delay,” said AHIMA CEO Lynne Thomas Gordon, MBA. “AHIMA will continue our work with various public sector organizations and agencies such as the Centers for Medicare & Medicaid Services (CMS), the Office of the National Coordinator for Health IT, and the National Center for Health Statistics (NCHS) along with our industry partners such as the ICD-10 Coalition so that ICD-10 will realize its full potential to improve patient care and reduce costs. These are goals that AHIMA and other healthcare stakeholders and our government leaders all share.”

Since the transition to ICD-10 “remains inevitable and time-sensitive because of the potential risk to public health and the need to track, identify and analyze new clinical services and treatments available for patients,” AHIMA said in a statement the organization will continue to lend technical assistance and training to stakeholders as they are forced to navigate the challenge of preparing for ICD-10 while still using ICD-9.

“There’s no integrity in what we’re getting ready to vote on,” remarked Senator Tom Coburn (R-OK) as he spoke against passage of the bill despite the pressing deadline. Drawing a comparison with the principles of medicine that you don’t treat symptoms but instead treat the disease, Coburn also noted that the continued passage of SGR patches represents a corruptible process that hides truth from the consumer and demonstrates a lack of transparency from Congress. Coburn also displayed a poster that he said characterized Congress’s current methods during his speech that read “Put Off Until Tomorrow What You Should Be Doing Today.”

This is the second time ICD-10 implementation has been delayed. The original compliance date of October 1, 2013, was officially pushed back a year on September 5, 2012, by CMS, who noted in their ICD-10 delay final rule that “some provider groups have expressed strong concern about their ability to meet the October 1, 2013, compliance date and the serious claims payment issues that might ensue if they do not meet the date.”

CMS has estimated that another one-year delay of ICD-10 would likely cost the industry an additional $1 billion to $6.6 billion on top of the costs already incurred from the previous one-year delay. This does not include the lost opportunity costs of failing to move to a more effective code set, AHIMA said.

The delay directly impacts at least 25,000 students who have learned to code exclusively in ICD-10 in health information management educational programs, AHIMA said in a statement.

“It is truly unfortunate that Congress chose to embed language about delaying ICD-10 into legislation intended to address the need for an SGR fix in their effort to temporarily address the long outstanding and critically important physician payment issues,” said Thomas Gordon.

Beth Walsh,

Editor

Editor Beth earned a bachelor’s degree in journalism and master’s in health communication. She has worked in hospital, academic and publishing settings over the past 20 years. Beth joined TriMed in 2005, as editor of CMIO and Clinical Innovation + Technology. When not covering all things related to health IT, she spends time with her husband and three children.

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