APR 30, 2014 5:17pm ET

CMS Still Shamefully Mum On ICD-10 Delay


Each morning when I wake, I open my eyes and say to myself: This could be the day that the Centers for Medicare and Medicaid Services actually provides guidance to providers, payers and others on the ICD-10 delay. It's a ritual I have been doing since April 1 when President Obama signed the law into effect delaying the ICD-10 implementation deadline by at least a year.

April showers have now brought May flowers but there is still nothing concrete from CMS that the healthcare industry can hang its hat on. Attendees at last week's ICD-10 summit in Washington hosted by the American Health Information Management Association were hoping to get any shred of information from Denise Buenning, acting deputy director of the CMS office of e-health standards and services. Buenning gave the closing presentation at the summit, but the best she could offer the audience was that an announcement would be made in the very near future.

CMS's handling of this whole ICD-10 delay has been troublesome, to say the least. Healthcare stakeholders have been left with the only thing they can do, which is to assume--despite any official announcement from CMS on the matter--that October 1, 2015 is the new ICD-10 deadline. A thin statement on the CMS Web site states that it is "examining the implications of the ICD-10 provision and will provide guidance to providers and stakeholders soon," repeating the legislative language that HHS may not, prior to October 1, 2015, adopt ICD-10 code sets.

Faced with a deafening silence from CMS, industry groups have been urging their constituents to stay calm and carry on. Today, the Workgroup for Electronic Data Interchange held a one-day "emergency industry summit" in Reston, Va., to provide an action plan in response to the ICD-10 delay and to discuss how implementation plans can continue to stay on track. Still, health systems are re-evaluating their implementation and training plans while they await guidance from CMS--without which they are left in a regulatory limbo.

Like other health systems across the country, Phoenix-based Banner Health--with 24 hospitals in seven states--is conducting an impact assessment of the ICD-10 delay to determine the path forward in terms of which organizational activities should stop, start or continue as part of their code conversion. "All the resource time that we're expending on this--the project management and all our team members--has a cost," Linda Martin, IT operations director for Banner Health, told Health Data Management

Charlotte, N.C.-based Premier, a collaborative healthcare alliance of more than 2,900 hospitals and nearly 100,000 other providers, in an April 24 letter to CMS Administrator Marilyn Tavenner urged the agency to implement ICD-10 on October 1, 2015, the earliest it has the authority to do so, and to quickly announce this intention to the public. "Clear and early guidance from CMS will provide stability in the provider community and guarantee that healthcare stakeholders have time to exercise due diligence in preparation for implementation to begin on October 1, 2015," stated the letter.

We all know too well that government agencies move at a snail's pace and that bureaucratic red tape can stand in the way of real progress in getting things accomplished in the public sector. However, the lack of formal guidance on the ICD-10 delay from CMS at this juncture--a month after legislation went into effect--is shameful and completely unfair to providers left to their own devices in planning for the inevitable code transition. When that will actually occur is anyone's guess. One can only hope in the promising morning light of each new day that we will all get word soon from CMS.   

Comments (3)
Let's try to understand something very important, CMS is the largest TPP in the Nation and it is a government running facility. CMS handle claims for the Disabled and elderly, who in fact use up most of the healthcare within the country. With all the categories used like DRG, NCD, LCD OPPS, IPPS and many other payment classifications. I am sure other third party payer's (TPP)are also glad to have the time to reevaluate and prepare more thoroughly. But it is unfortunate for the providers of service who have already prepared for the transition, non the less they are still prepared for 10/2015 they now have the time to make really be ready for the transition. Let's just hope that we don't have another pit fall like the one we had in April 2014.
Posted by Daniel F | Thursday, May 01 2014 at 9:42AM ET
I think this article should have been titled "US Legislature shamefully involved in ICD10 Transition". Why are you beating up CMS? They were pronouncing day after day and week after week that ICD10 was going forward in October 2014. There was no wavering, no backing off, and a clear date for the entire industry to abide by. CMS could not have been more clear about where it was going.

This override by the legislature was a first. For an agency to be overturned by the legislature on an administrative initiative leaves its decision process where exactly??? We should be writing our congressmen, not CMS. So, if CMS says, ok, the new date is October, 2015, and that horrendous sentence is left in the 'fix' legislation again next year, what will happen? Let's ask our legislators, 99.9% of whom have no idea what they voted on in terms of ICD10, what they would like for the industry to do about ICD10! The response will be deafening.
Posted by Susan P | Thursday, May 01 2014 at 10:41AM ET
CMS was not ready: another example of government bureaucratic incompetence. The AMA rightfully influenced the legislature to delay ICD-10 implementation. CMS was warning doctors to be prepared that their payments could be delayed with ICD-10 implementation up to six months, because they were unable to provide for sufficient testing in advance of implementation. Sound familiar? Will CMS be ready for implementation by Oct 1, 2015? If they are not prepared to allow adequate testing in advance of implementation, then they are not ready. Don't bet on it.
Posted by Bill H | Thursday, May 01 2014 at 12:56PM ET
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