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SGR repeal, ICD-10 delay legislation passes in the House

By Kyle Murphy, PhD

After this morning’s postponement of proceedings concerning HR 4302 (Protecting Access to Medicare Act of 2014), the House of Representatives reconvened to consider unfinished business and a voice vote in favor of passing the patch for the Sustainable Growth Rate (SGR) that contains the provision to delay ICD-10 until October 2015. The focus now shifts to the Senate, which must consider and vote of the bill before it finds its way to the President’s desk.

So what does the passing potentially mean for the healthcare industry? EHRIntelligence.com caught up with the head of the College of Healthcare Information Management Executives (CHIME) President and CEO Russell P. Branzell, FCHIME, CHCIO, to discuss the implications.

What is CHIME’s response to the proceedings?

We’re generally not pleased that something as critical as ICD-10 becomes fodder for other legislation. That’s an area that needs to either stand on its own and/or be discussed on its own. When you start combining all these programs together, none of them can be looked at on its own merits and concerns. In particular, a majority of our membership has put substantial time, energy, and dollars in to getting their systems ready for ICD-10, and I would actually say a vast majority of our members are ready, have plans to be ready on a reasonable timeframe between now and October.

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How would the delay impact healthcare organizations and providers?

If the AHIMA numbers are even close to being correct, which I believe they are, this is going to cost the industry substantial amounts of money in the tune of $1 to $6 billion dollars, but most importantly loss of momentum and energy around something that really is important. We’re level for the next level of financial reform. We’re ready for this data to be used appropriately by the right constituencies, including our research and academic institutions. I heard from one CIO, who is indicative of other academic centers, is that they are literally making plans for post-October 1 for this to advance their research and clinical academic programs. So why would we delay that if the majority of the environment is ready and a majority know how and what they are going to use it for?

Who is driving and what is the rationale behind the proposed ICD-10 delay?

I understand where it came from; I actually also understand the argument of those who are making it that it should be delayed. Most of this concern sounds like it’s coming from physicians, especially in specialty environments, but there are different ways to do it other than delaying this. You could go to only the hospital side moving to ICD-10 and leave physician-based payment on ICD-9, which is what they did in Canada for years. You could go to another model where we even did dual billing for several years and use this as a migration tool. But the thing that needs to be reprioritized from a timing perspective is actually meaningful use, which everybody has concerns about. The majority of hospitals, which also include a majority of the physicians employed within them, are comfortable with the timeframe of ICD-10. Why would we delay that and not being looking at the other timeline?

This came as a surprise, I would believe, to the executive branch because I heard even as of yesterday morning Marilyn Tavenner was talking to a group and still discussing that there would be no delay to ICD-10. There are lots of other things in the bill that are appropriate and need to be corrected. They need to deal with SGR, the overnight rule, and several other things that are in there. Those are appropriate. But when you include things in there that should stand on their own, you tend to create collateral damage




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