The US Senate is scheduled to vote on a bill on Monday that includes language delaying ICD-10-CM/PCS implementation until at least October 1, 2015.
According to the United States Senate’s floor schedule, senators will “convene and begin consideration” of H.R. 4302, Protecting Access to Medicare Act of 2014, at 2 p.m. on Monday, March 31. A vote on the bill is expected to take place.
The H.R. 4302 bill, which was narrowly passed under uncommon circumstances by the US House of Representatives on Thursday, mainly adjusts the Sustainable Growth Rate (SGR) for Medicare payments, which dictates how much physicians get paid for services. But section 212, a seven line section inserted into the SGR patch bill, also states that the Department of Health and Human Services (HHS) cannot implement the ICD-10 code set until at least October 1, 2015, a year later than the current date of October 1, 2014. (For full coverage of the House vote and the impact of an ICD-10 delay on the healthcare industry, click here.)
The bill introduced by Representative Joe Pitts (R-PA) states: “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 13 Social Security Act (42 U.S.C. 1320d–2(c)) and section 14 162.1002 of title 45, Code of Federal Regulations.”
The Senate will vote on the House’s H.R. 4302 bill, and not a previously introduced Senate bill, S. 2157, which looked to enact wider reform of SGR. The Senate will conduct an “up or down” vote on the bill, which means senators would not be able to remove any sections of the bill, including the ICD-10 delay provision, before a vote. Therefore AHIMA and other proponents of ICD-10 have asked healthcare stakeholders to contact their senators and tell them to vote against H.R. 4302.
Congress is working against a deadline of March 31 to reform or patch the SGR before it directly impacts physician payment. Physician groups, including the American Medical Association, have come out against H.R. 4302 since it does not provide a long-term solution to the SGR issue. The insertion of the ICD-10 delay section into H.R. 4302 was likely done to placate physicians who are against an SGR patch. The AMA has said they are against moving to ICD-10.
On March 26 a coalition of nearly 90 state and national medical societies issued a letter to congressional leaders saying they oppose H.R. 4302 and asked them to scrap the bill for larger reform of Medicare payments.
AHIMA officials have said that another delay in ICD-10 will cost the industry money and wasted time implementing the new code set. Groups opposing ICD-10 have said that the implementation, with its large increase in codes and need to adapt healthcare systems, causes an unnecessary burden on providers.
“The transition to ICD-10 is time sensitive because of the urgent need to keep up with tracking, identifying and analyzing new clinical services and treatments available to patients. Continued reliance on ICD-9 is not a viable option when considering the risk to public health and the danger of relying on outdated and imprecise data,” AHIMA officials said in a statement.
“The healthcare industry has had an abundance of time to prepare for the transition to ICD-10. Many hospitals, healthcare systems, third-party payers and physicians’ offices have prepared in good faith and made enormous investments to be ready for the Oct. 1, 2014, deadline and the transition to ICD-10, an essential and robust coding system that will lead to improved patient care, reduced costs and maximize the investments in electronic health records (EHRs) and health data exchange,” the statement reads.
In addition to impacting the delivery of care, a delay in ICD-10 impacts more than 25,000 students in health information management (HIM) associate and baccalaureate educational programs, many of whom have learned to code exclusively in ICD-10, according to AHIMA.
“These students will not have the ability to code in ICD-9, which will make it difficult for them to find employment, pay back student loans, and become certified,” the statement said. “In the bigger picture, it is a further blow to a healthcare system already struggling to fill positions with qualified personnel as the demand for quality healthcare data increases.”
AHIMA Calls on Members to Request Removal of Delay Provision
AHIMA has put out a call to members and other stakeholders to contact their senators and ask them to pass a clean bill to fix SGR and not delay ICD-10.
When contacting congressional members, AHIMA has instructed callers to state that their senators should:
- Oppose the specific ICD-10 related language in the SGR patch legislation
- Reach out to Senate Majority Leader Harry Reid and Senate Chairman Ron Wyden to vote against H.R. 4302 and remove the ICD-10 language from any future bill
The Centers for Medicare and Medicaid Services estimates that a one-year delay could cost between $1 billion to $6.6 billion, according a statement from AHIMA officials. “This is approximately 10-30 percent of what has already been invested by providers, payers, vendors and academic programs in your district,” AHIMA wrote in a statement, which it encouraged its members to use when contacting Congressional representatives. “Without ICD-10, the return on investment in EHRs and health data exchange will be greatly diminished… Let Senate Majority Leader Reid and Chairman [Ron] Wyden know that a delay in ICD-10 will substantially increase total implementation costs in your district.”
In addition to asking ICD-10 proponents to take to social media and contact senators, AHIMA will also be conducting a Twitter Chat on the potential ICD-10 delay at 10 a.m. CT, Monday, March 31, before the Senate votes. The hashtag #NoDelay will be used in the chat, and discussion will center on individuals’ opinion on an ICD-10 delay, discuss the amount of resources organizations have already invested in ICD-10, and discuss what individuals’ biggest concerns are regarding a potential delay.
Contacting Your Congressional Representatives
For more information on contacting your senators in Congress, visit AHIMA’s Advocacy and Public Policy senator look-up site at http://capwiz.com/ahima/dbq/officials/. Comments on this article are not forwarded to government officials.
For more information on AHIMA ICD-10 advocacy, visit http://www.ahima.org/about/advocacy.