ICD-10 Legislative Review Webinar Highlights Political Maneuvering, Next Steps

Members of AHIMA made their voices heard “loud and clear” in the days leading up to the signing of legislation that officially delayed government implementation of ICD-10-CM/PCS, said AHIMA’s director of congressional relations, Margarita Valdez, in an AHIMA webinar on Friday.

During the webinar, “ICD-10: A Legislative Review,” Valdez and Sue Bowman, MJ, RHIA, CCS, FAHIMA, AHIMA’s senior director, coding policy and compliance, gave AHIMA membership a play-by-play of the congressional maneuvering that resulted in the legislation to delay ICD-10 implementation. They also outlined advocacy strategies in which AHIMA members can take part to help prevent the use of ICD-10 implementation as a bargaining chip in future congressional legislation.


Unusual, Unprecedented Circumstances Surrounded H.R. 4302

Valdez explained that the procedures employed by leadership in the House of Representatives, which resulted in the inclusion of ICD-10 language in H.R. 4302 “Protecting Access to Medicare Act of 2014,” was “completely out of the ordinary” and “unprecedented.” The ICD-10 delay was attached to legislation that served as a one-year patch to the Sustainable Growth Rate (SGR), a formula used by Medicare to reimburse physicians.

477455801The ICD-10 provision was added as a “carrot” to physician groups who wanted a permanent fix to the SGR and who generally are opposed to ICD-10. The reason the vote on the bill came as such a surprise to Congress watchers is because the bill was placed by House Speaker John Boehner (R-OH), on the “suspension calendar.” This meant that the House could suspend traditional voting requirements and vote on the bill with an up or down voice vote, by only the Representatives present when a vote is called to order, instead of a roll call vote.

Under suspension rules, 40 minutes of debate are typically allotted for Representatives to express opposition to a bill. However, in the case of H.R. 4302, the Speaker called for a recess and then called for the House to reconvene and vote before most Representatives were even aware the vote was going forward. The bill was passed with five or six House members present, before moving along to the Senate.

Senate Finance Committee Chairman Ron Wyden (D-OR) was unable to pass a Senate version of the House bill that did not contain a delay in ICD-10 implementation, so the bill was signed into law by President Obama on April 1.


AHIMA Outlines Next Steps for Members

Valdez assured AHIMA members that their efforts to thwart the ICD-10 delay were significant. AHIMA recorded 10,000 calls to members of Congress through the association’s Advocacy Assistant, though the total number is estimated to be much higher when including members who called using other methods such as a script provided through AHIMA e-alerts. Over 35,000 members viewed the action alert; over 6,000 Facebook users “liked” the alert; and over 5,500 Twitter subscribers sent tweets using the hashtag #NoDelay.

Valdez encouraged AHIMA members to keep pressure on their Representatives and Senators by continuing to flood their legislative offices with calls, letters, and e-mails. The easiest way for members to do this is through AHIMA’s Advocacy Assistant, which provides form letters and scripts to guide comments. While form letters and scripts are provided, Valdez said members should edit the letters to be more specific. “Drive home these issues, share specific costs and efforts, specific to home state. Let them know ramifications of not implementing in your state and district,” Valdez encouraged.

Bowman said that AHIMA will continue to work with the Coalition for ICD-10, a coalition of healthcare stakeholders working to oppose further delays to ICD-10. Bowman says she’s been asked several times why the Centers for Medicare and Medicaid Services or the US Department of Health and Human Services have yet to weigh in on the delay.

“It’s not because they’re on vacation, but because they’re working on legal language, process for new compliance date. They’re working very hard,” Bowman said.

Several people have inquired about the likelihood of drafting new legislation to remove the implementation delay, Bowman and Valdez said.

“Since this is an election year in the House, unless it was introduced, had a hearing, and was passed, the likelihood of passing a rescind bill before October is almost slim to none,” Valdez said.


Webinar Recording Available

Though Friday’s webinar reached capacity with 2,030 registrants, a recording is available at https://cc.readytalk.com/cc/playback/Playback.do?id=curu7i.


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