Updated on: March 17, 2016

ICD-10 Delay Now Law

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Original story posted on: April 3, 2014

Without fanfare or a Rose Garden ceremony, President Barack Obama signed into law the Protecting Access to Medicare Act of 2014 as expected Tuesday afternoon.

The president’s signature on the bill prevents a scheduled 24-percent cut to Medicare physician payments, which would have kicked in on April 1. The legislation also delays for at least one year the implementation date for ICD-10, a move coming one day after the White House touted that 7.1 million Americans had enrolled in the government’s Health Insurance Marketplace.

 

Earlier this week, on Monday, the U.S. Senate passed H.R. 4302 to extend the Sustainable Growth Rate (SGR) while at the same time delaying the implementation of ICD-10 for at least one year. The vote was 64-35, as reported by ICD10monitor.

The provision for extending the ICD-10 delay was tucked into the earlier House bill as a temporary measure the industry has come to call the “doc fix.” By voting for it, Congress was able to sidestep for the 17th time the repeal of the contentious SGR formula that was incorporated into the 1997 Balanced Budget Act. At the time, Congress saw the SGR as a means with which to rein in Medicare reimbursement to physicians. Annual “doc fixes” to temporarily repeal the SGR have come to characterize the inability of Congress to resolve controversial issues.

Cost and Credibility

The cost of the new delay was certainly on the mind of healthcare consultant and former Cleveland Clinic Hospital Vice President of Revenue Cycle Lyman Sornberger, who during his tenure committed the system to be among the nation’s earliest adopters of ICD-10.

“Cost estimation of the delay for a 300-600 bed hospital is (between) $250,000 to $450,000,” said Sornberger now

CEO and president of LGS Health Care Consultants. “The cost estimation of the delay to hospitals with bed size of greater than 1,000 beds is in excess of $750,000.”

With the delay comes mounting skepticism, as this marked the third time action taken by the president delayed the nation’s healthcare system’s attempts to adopt ICD-10.

In 2009, the U.S. Department of Health and Human Services (HHS) published a final rule establishing an October 2012 deadline for ICD-10 compliance.

Under pressure from the American Medical Association (AMA), among other groups, the deadline for implementing ICD-10 was extended to October 2013 when on Aug. 24, 2012, HHS Secretary Kathleen Sebelius announced a rule finalizing a one-year delay. Sebelius at the time explained that more time was needed for covered entities to prepare for the change and to fully test systems.

“Most in the industry will not trust the 2015 new date and take it less serious after two delays, and (they will) now re-deploy resources,” wrote Sornberger in an email to ICD10monitor. “Diligent providers, payors, and vendors will now slow down on the internal cost and financial exposure analysis.”

Paul Weygandt, MD, vice president of physician services for J.A. Thomas & Associates, a Nuance Company, told ICD10monitor that delay should have “minimal” impact on entities that ignored the deadline, although the opposite will be true for those that were on target for complying with the October 2014 deadline.

“The impact of those who have tried, in good faith, to be compliant will be profound,” wrote Weygandt in an email to ICD10monitor. “Those organizations that have already spent large sums of money to provide education to physicians and hospital employees will have essentially wasted those efforts. The potential to retain information that is not put into practice information is minimal.”

Sornberger too is concerned about the provisions in the law that prohibit HHS from implementing ICD-10 before October 2015.

“The value to 2015 is diluted by ‘why not ICD.11 and 2017?’,” Sornberger wrote.

 

Chuck Buck

Chuck Buck is the publisher of ICD10monitor and is the executive producer and program host of Talk Ten Tuesdays.