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Senate Passes SGR: ICD-10 Implementation Delays Unlikely

By Vera Gruessner

- The long-awaited Senate stance on the new SGR bill was unmasked when the Senate approved the legislation on Tuesday, April 14. This effectively puts an end to a flawed formula for Medicare payments as well as any ICD-10 implementation delays. The Medicare Access and CHIP Reauthorization Act was passed 92-8 and now awaits the signature of President Barack Obama before it becomes law, according to Politico.

ICD-10 Preparation

With the passage of the SGR bill through the Senate, there is now very little risk to the ICD-10 transition deadline. Since there was no language regarding ICD-10 implementation delays in the latest version of the SGR bill, healthcare providers and IT developers can expect the ICD-10 implementation deadline to take place as scheduled on October 1, 2015.

The eight republicans who voted against the bill include Senators Marco Rubio, Ted Cruz, Richard Shelby, Mike Lee, Ben Sasse, Tim Scott, Jeff Sessions, and David Perdue. This bipartisan policy agreement marks an important advancement among policymakers, as the majority of healthcare legislation has been at a standstill since the passage of the Patient Protection and Affordable Care Act five years ago.

House Speaker John Boehner and Minority Leader Nancy Pelosi took part in negotiating the SGR legislation, which was passed mere hours before physicians would have seen a significant cut in their Medicare payments.

The Sustainable Growth Rate formula has now been replaced with a more effective Medicare payment equation. Instead of cutting payments to physicians, this new bill will actually increase payments annually by 0.5 percent starting on July 1 and lasting through 2019.

“Passage of this historic legislation finally brings an end to an era of uncertainty for Medicare beneficiaries and their physicians—facilitating the implementation of innovative care models that will improve care quality and lower costs,” AMA Executive Vice President and CEO James L. Madara, MD, said in a public statement. “Patients will be able to get the care they need and deserve.”

Fears around additional ICD-10 implementation delays are generally unfounded, as the legislation has gone through Senate without any significant opposition. The reasoning behind the potential for an ICD-10 delay is due to a last-minute addition that was included in SGR legislation in 2014 that pushed back the ICD-10 implementation deadline to October 2015.

The American Health Information Management Association (AHIMA) stated last month that ICD-10 implementation delays should not be expected and providers should get ready for transitioning to the new coding set by October 1. It is likely that any further ICD-10 implementation delays would only hurt the healthcare sector and providers ready for the transition.

Earlier this month, RevcycleIntelligence.com interviewed Sue Bowman, MJ, RHIA, CCS, FAHIMA, Senior Director, Coding Policy and Compliance, of the American Health Information Management Association (AHIMA), who discussed the new SGR bill and any implications for more ICD-10 implementation delays. Bowman explained that another postponement won’t actually help the industry.

“We’ve already had two delays and one thing that’s very evident from both delays is the fact that they didn’t help anyone,” Bowman said. “In fact, people tended to get more behind and less on track as a result of the delay. What happened with the delay is kind of like anytime you get an extension on something – what do you do? You put it aside and you wait until the date is closer.”

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