Senate Passes Protecting Access to Medicare Act of 2014, Pushes ICD-10 Compliance Date Back

Delay of ICD-10 Now in the Hands of the President

It’s been a whirlwind few days for the healthcare industry. Last Thursday the House of Representatives approved a bill to fix the Sustainable Growth Rate (SGR) formula for Medicare physicians facing a 24% reimbursement cut scheduled to start today. The bill also includes a controversial addition: the delay of ICD-10.

Yesterday, the Senate voted 64 to 35 to pass H.R. 4302, Protecting Access to Medicare Act of 2014, preserving the Medicare pay rate for physicians and pushing back the ICD-10 compliance date of October 1, 2014 to at least October 1, 2015.

An official statement from the American Health Information Management Association (AHIMA) was quickly issued:

“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, RHIA, CAE, FACHE, FAHIMA. 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 will continue to help lend technical assistance and training to stakeholders as they are forced to navigate the challenge of continuing to prepare for ICD-10 while still using ICD-9. It has been 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 already incurred costs from the previous one-year delay.  This does not include the lost opportunity costs of failing to move to a more effective code set.

The EHR vendor community also has a stake in the delay, with athenahealth’s EVP Ed Park providing the following comment in a company press release:

“It is unfortunate that the government has once again chosen to delay ICD-10. athenahealth and its clients are/were prepared for the ICD-10 transition, and in fact we have national payer data showing that 78 percent of payers are currently proving readiness in line with the 2014 deadline. The moving goal line is a significant distraction to providers and inappropriately invokes massive additional investments of time and money for all. The issue is even more serious when considered in association with another short-term SGR fix and 2013’s Meaningful Use Stage 2 delay. It is alarmingly clear that health care is operating in an environment where there is no penalty for not being able to keep pace with necessary steps and deadlines to move health care forward. Our system is already woefully behind in embracing technology to drive information quality, data exchange, and efficiency, and delays like this only hinder us further.”

NextGen also issued a statement following the vote. Michael Lovett, executive vice president and general manger provided the following comment:

The Senate’s vote to patch the SGR and delay ICD-10 for another year doesn’t impact our commitment to helping move healthcare forward or our focus on preparing clients to meet all regulatory deadlines. We agree that ICD-10 is of tremendous importance to emerging value-based payment models and to the efficient delivery of quality care; we also view the move to data driven healthcare as a significant step in the right direction. However, we as a healthcare community must now look beyond the delay and focus on other reform initiatives as well as looming Meaningful Use deadlines. We need to remind providers that ICD-10 and Meaningful Use are complementary initiatives, and providers would be well-suited to focus on both.

There are, of course, many questions and issues still to be addressed here with the likely delay of ICD-10. First and foremost, though, read and keep up with Tom Sullivan’s latest coverage on this unfolding story on Government HealthIT. He’s been ahead of this story from the start. In his latest piece he writes that “the provision to delay ICD-10 may go largely unnoticed in the general citizenry,  yet it was among the flaws that sparked something of an uproar in the healthcare realm, where the code set conversion is among the most contentious issues.”