ICD-10 Delay Soon Could be Back on Table

Congress during the month of March expects to once again attempt a permanent fix to the Medicare Sustainable Growth Rate formula for reimbursing physicians, and a delay in the ICD-10 compliance date could be in the mix, just as it was last year when the date was moved to Oct. 1, 2015.


Congress during the month of March expects to once again attempt a permanent fix to the Medicare Sustainable Growth Rate formula for reimbursing physicians, and a delay in the ICD-10 compliance date could be in the mix, just as it was last year when the date was moved to Oct. 1, 2015.

Rep. Pete Sessions (R-Tex.), chair of the House Rules Committee, “has been meeting with physicians and discussing how ICD-10 will affect all parties in the medical community,” a spokesperson tells Health Data Management. “He has been thoughtfully looking into this issue but no legislation has been drafted.”

As Congress closed its 2013-2014 session in December, physicians put pressure on members to revisit the ICD-10 compliance date and implement a new two-year delay. On Dec. 10, Sessions and Rep. Fred Upton (R-Mich.), chair of the House Energy and Commerce Committee, in a statement indicated a committee hearing would come in early 2015 as they “heard from a number of interested parties concerned about falling behind or halting progress.” A few days later, they backed off somewhat, indicating support for the current compliance date but pledging to take a hard look at the state of ICD-10 preparedness. “It is our priority to ensure that we continue to move forward in health care technology and do so in a way that addresses the concerns of all of those affected and ensure that the system works.”

During a February hearing of the Energy and Commerce subcommittee on health, members voiced support for the current ICD-10 deadline, although Rep. Michael Burgess, M.D., (R-Tex.) voiced concern about whether the Centers for Medicare and Medicaid Services would be ready. Of seven testifying witness, only one, a physician, supported a delay. Said subcommittee chair Rep. Joseph Pitts (R-Penn.), “We need to end the uncertainty in my opinion and move forward to full implementation of ICD-10.”

That doesn’t mean that the debate is over, as revisiting SGR opens the opportunity to add amendments covering other issues into a SGR bill, whether Congress fixes the payment mechanism or simply puts another bandage on it.

As chair of the Rules Committee, Sessions is influential, and Burgess, a physician is well respected, says Robert Tennant, senior policy advisor at the Medical Group Management Association. Tennant is surprised to see the issue back on the table, but not surprised that Sessions may be leading it, as he has heard the concerns of constituents and may be projecting those concerns. “Anytime a member of the leadership team talks about something, it carries more weight.”

And there are other House members sympathetic to the arguments of physicians, he adds. They include Rene Ellmers, R.N., (R-N.C.), Tom Cole (R-Okla.), Louise Slaughter (D-N.Y.) and Virginia Foxx (R-N.C.), among others.

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