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MGMA Objects to IPPS Provisions


June 13, 2008

The Medical Group Management Association has sent a letter to the Centers for Medicare and Medicaid Services voicing concerns about proposed changes to the hospital inpatient prospective payment system that would affect physician practices.

CMS recently announced that Medicare will no longer reimburse hospitals for treatment resulting from certain medical errors, called “hospital acquired conditions” or HACs. In the proposed inpatient payment rule for fiscal 2009, the agency seeks comment on moving to the ICD-10-PCS code set to more granularly identify HACs.

MGMA opposes a rapid transition to ICD-10, according to MGMA’s letter to Kerry Weems, acting CMS administrator. “Complex software and business process changes must be completed before ICD-10 could be utilized,” the letter states. “Transitioning too rapidly to ICD-10 would create significant problems for the entire health care industry, especially providers. Before any move to ICD-10, there must be a national implementation plan, a cost-benefit analysis, code set crosswalks, and full implementation of the HIPAA 5010 standards. We recommend mandating extended compliance timelines in recognition that the transition to ICD-10 will be extremely challenging and costly for the entire industry, particularly small and medium-sized physician practices.”

MGMA also strongly objected to the prospect of applying the HAC non-payment policy beyond hospitals, especially to physician practices. Further, the Englewood, Colo.-based organization called for a “time out” on proposed changes to Phase III Stark physician self-referral rules five months from the effective date of the rules. “The possible ‘tweaking’ of the rules in just this one regulatory round takes many times more words in the Federal Register to explain than the entire statutory scheme occupies in the U.S. Code,” according to the letter.

For a copy of MGMA’s letter to Weems, click here.

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