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SGR Patch Bill Proposes ICD-10 Delay; Vote Expected Thursday

 |  By smace@healthleadersmedia.com  
   March 26, 2014

A House bill addressing Medicare reimbursement rates for physicians contains language that would postpone the ICD-10 deadline until October 1, 2015.

Another healthcare reform-related federal deadline may be delayed. This time it's the ICD-10 deadline, which has already been delayed once.

The American Health Information Management Association Wednesday alerted its members that Congress will vote Thursday on a bill, negotiated at the leadership level in the House and Senate, which contains a provision that would delay implementation of ICD-10 for another year, until October 1, 2015.

The main focus of the proposed bill, expected to be voted on Thursday in Congress, would be to patch the Sustainable Growth Rate formula which dictates Medicare reimbursement rates for physicians.

In a statement released late Wednesday, American Medical Association President Ardis Dee Hoven, MD, said her group "and other physician groups are calling on House members to vote no on this legislation. Full repeal of the Sustainable Growth Rate is the answer to strengthening the Medicare program, not another patch."

Section 212 of the proposed bill states that "The Secretary of Health and Human Services may not, prior to October 1, 2015, adopt ICD–10 code sets as the standard for code sets under section 1173(c) of the Social Security Act (42 U.S.C. 1320d–2(c)) and section 162.1002 of title 45, Code of Federal Regulations."


Senate Doc Fix Vote Expected Monday


In February, Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner, speaking at the HIMSS 2014 conference in Orlando, stood firm on the October 1, 2014 ICD-10 deadline. "Let's face it guys; it's time to move on," Tavenner said. "There will be no change in the deadline for ICD-10. CMS began installing and testing systems for ICD-10 in 2011. All fee for service systems at CMS are ready."

According to an AHIMA blog post on Wednesday, CMS estimates that a one-year delay could cost between $1 billion to $6.6 billion. "This is approximately 10–30% of what has already been invested by providers, payers, vendors, and academic programs," AHIMA stated. "Without ICD-10, the return on investment in EHRs and health data exchange will be greatly diminished."


AMA Seeks to Stop ICD-10, Cites Soaring Costs


AHIMA urged its members to call Congress to oppose the ICD-10 deadline extension. The AMA and other industry groups have been vocal in their desire for a deadline extension.

If the bill passes and ICD-10 is delayed again, it would be another instance of HHS relaxing deadlines and amending policies in response to stakeholder concerns. In February, CMS relented to pressure from physicians, payers, hospitals, and lawmakers and announced it would perform limited end-to-end ICD-10 testing.

Days away from the March 31 deadline to enroll in the federal insurance marketplace, the White House said Tuesday night that it would allow more time for some applicants. HHS Secretary Kathleen Sebelius, in a Congressional hearing March 12, stated that the enrollment deadline would not be delayed.

SGR Patch Bill by HLMedit

Scott Mace is the former senior technology editor for HealthLeaders Media. He is now the senior editor, custom content at H3.Group.

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