Congress Needs to Hold Hearings on ICD-10 Delay, Say Supporters

With President Obama's April 1 signing of legislation into law delaying ICD-10 implementation to October 2015, supporters of the one-year extension believe that now is the time for Congress to get more actively involved in the code switchover. Despite including legislative language calling for the ICD-10 delay in the Protecting Access to Medicare Act of 2014, they say lawmakers have been relatively silent on the issue.

As proof, they point to the fact that ICD-10 wasn't mentioned even once in congressional debate of the bill in the run up to the House and Senate votes that ultimately passed the legislation. What's more, they argue, no congressional hearing has ever been held on the subject to exclusively examine the potential impact of ICD-10 implementation on the healthcare industry.  

"Members of Congress have abdicated their responsibilities. What they have to do now is to start to do real oversight," Robert Moffit, senior fellow in the Center for Health Policy Studies at The Heritage Foundation, told Health Data Management. "It's amazing that something of this enormity would go under the radar for so long. It's very much an inside baseball kind of thing. Trade associations and health policy specialists know about this. But, outside of that tiny community, most folks are just simply not aware of this."

The ICD-10 delay "is an opportunity for Congress to really start to get into this," Moffit said. "The delay will hopefully give the proponents and opponents of ICD-10 an opportunity to make their case in a public forum before Congress."

Up until now, he said ICD-10 has been "an administrative decision" by the Centers for Medicare and Medicaid Services, which will have a huge impact on physician practices and on healthcare systems. "CMS are not the lawmakers. Laws are to be made by Congress," he added. "This is an exercise of regulatory authority. This country is not supposed to be governed by regulators. There has got to be a public debate about this and that means congressional hearings."

Moffit applauded legislative efforts last year by Congressman Ted Poe (R-Tex.) and Senator Thomas Coburn (R-Okla.) to block ICD-10 implementation and require the comptroller general of the United States to conduct a study on the impact of a transition from ICD-9 to ICD-10 and make legislative recommendations.

Robert Tennant, senior policy advisor at the Medical Group Management Association, credited the three Republican physicians serving in the Senate, including Coburn, for raising concerns about ICD-10. "It certainly wasn't as public perhaps but there was certainly a lot of interest and a lot of expertise on Capitol Hill in this area," said Tennant, who emphasized that the ICD-10 delay provision in H.R. 4302, the Protecting Access to Medicare Act of 2014, originated in the House "where the committees of jurisdiction have the most sway."

He argued in a separate Health Data Management article that House and Senate passage of legislation delaying the ICD-10 deadline is proof that the overall approach to the code switchover is flawed and CMS must "reset" the process.