Reaction to ICD-10 Delay Mixed Ahead of Senate Vote on ‘Doc Fix’

March 28, 2014 in News

On Monday, the Senate is scheduled to vote on a bill (HR 4302) that would implement a temporary fix for Medicare’s sustainable growth rate formula and delay the ICD-10 compliance deadline until 2015, The Hill‘s “Floor Action” reports.

Senate Majority Leader Harry Reid (D-Nev.) announced the upcoming vote on Thursday, after the House approved the measure by voice vote (Cox, “Floor Action,” The Hill, 3/27).

Background on ICD-10

U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures. The switch means that health care providers and insurers will have to change out about 14,000 codes for about 69,000 codes.

In August 2012, HHS released a final rule that officially delayed the ICD-10 compliance date from Oct. 1, 2013, to Oct. 1, 2014, partially to look at the incremental changes needed in reforming health care.

Last month, CMS Administrator Marilyn Tavenner told an audience at the Healthcare Information and Management Systems Society’s annual conference that there would be no more delays to the ICD-10 compliance deadline.

How Bill Would Affect ICD-10

The House-approved “doc fix” proposal, introduced by Rep. Joseph Pitts (R-Pa.), would push back the ICD-10 compliance date to 2015.

The measure states, “The Secretary of Health and Human Service may not, prior to Oct. 1, 2015, adopt ICD-10 code sets as the standard for codes sets.” It also cites sections in the Social Security Act and the Code of Federal Regulations, which contain the secretary’s authority to mandate the new code sets.

CMS estimates that a one-year delay of ICD-10 could cost between $1 billion and $6.6 billion, according to a blog post by the American Health Information Management Association, which opposes the bill (iHealthBeat, 3/27).

Health Care Industry Divided on ICD-10 Delay

Many hospital CIOs have expressed concern over the possible delay of the ICD-10 deadline, noting the amount of training and funding that has been spent on the conversion, FierceHealthIT reports.  

Linda Reed, CIO of Atlantic Health System in New Jersey, said, “From a hospital perspective, enough already. We’ve spent the money, done the work and started all the training.” She added that from a physician perspective, another year-long delay is unlikely to solve implementation issues.

Similarly, Roger Neal — vice president and CIO at Duncan Regional Hospital in Oklahoma — said, “Too many investments in time and money have gone in on [ICD-10] to just say ‘nope, not doing it’” (Bowman, FierceHealthIT, 3/27).

In addition, Brian Patty — chief medical information officer at HealthEast Care System in Minnesota — said the decision could jeopardize hospitals’ relationships with affiliated providers. He said, “I think that the lost good will we’ve had with our providers will be the biggest hit.”

However, other health care providers welcome the proposed delay, Modern Healthcare reports.

Terry Gunn, CEO of KershawHealth in South Carolina, said the delay would give the hospital more time to get ready for the “huge, overwhelming task” of ICD-10 implementation (Conn et al., Modern Healthcare, 3/27).

After the House vote, Medical Group Management Association senior policy adviser Robert Tennant said that the proposed delay is “recognition that the industry is simply not ready for the transition” (iHealthBeat, 3/27).

However, in an interview with EHR Intelligence, Tennant acknowledged the difficulty of the matter, saying, “There is no win across the board. If they delay it, then those folks that are ready and that do agree with the change and want it … well, they’re not going to be happy … [a]nd if you keep a hard date and the system fails, then that’s simply unacceptable.”

He added, “The reality is that we have to keep the health care system working,” noting, “The most important thing, at least in my mind, is that the claims continue to get paid and patients are seen” (Bresnick, EHR Intelligence, 3/27).

John Halakama, CIO of Beth Israel Deaconess Medical Center in Boston, also appeared conflicted about a delay. He said, “I can see both sides,” noting that “the hospital mechanism is ready,” while acknowledging that carrying out the transition is much more difficult for physician practices (Walsh, Clinical Innovation Technology, 3/27).

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