Will Congress include Another ICD-10 Delay in SGR Fix?

Next week, the House Energy and Commerce Subcommittee on Health will hold two days of hearings in an effort to find a permanent solution to the flawed Sustainable Growth Rate (SGR) formula. It’s also possible that this year’s congressional SGR fix could include a further ICD-10 delay.


Next week, the House Energy and Commerce Subcommittee on Health will hold two days of hearings in an effort to find a permanent solution to the flawed Sustainable Growth Rate (SGR) formula.

At the hearings scheduled for Jan. 21 and 22, lawmakers will discuss “how to bring SGR reform to the president’s desk before the current patch expires at the end of March 2015,” according to an announcement by the subcommittee. It’s also possible that this year’s congressional SGR fix could include a further ICD-10 delay.

Last year, the House and Senate passed legislation—the Protecting Access to Medicare Act—that included a provision to delay the ICD-10 deadline by one year to Oct. 1, 2015. President Obama signed the so-called “doc fix bill” into law delaying ICD-10 implementation to this October as well as delaying Medicare payment cuts to physicians until April 1, 2015.

With the start of the new 114th Congress and as the SGR deadline looms, ICD-10 could again be on the legislative agenda. “Subcommittee members will look to build upon the bipartisan, bicameral agreement on policy reached in the 113th Congress,” states the subcommittee’s announcement regarding the SGR hearings. Witnesses to testify at the SGR hearings have yet to be announced.

Last month, the House Energy and Commerce Committee also issued a statement that it is prepared to hold a congressional hearing on ICD-10 in 2015. The committee’s interest in ICD-10 came at the same time that a letter from the Medical Society of the State of New York to Speaker of the House John Boehner (R-Ohio) was circulated to other members of Congress requesting the ICD-10 deadline be pushed back to October 2017.

Industry groups opposed to further ICD-10 delays were concerned late last month that a $1.1 trillion spending bill to fund almost all of the federal government for fiscal 2015 might contain language to delay the current ICD-10 compliance date. However, in the end, those fears were not realized.

For its part, the American Health Information Management Association strongly supports the October 1, 2015 deadline for implementing ICD-10. “The industry has already seen two delays in implementation, and each delay has cost the industry billions of dollars, as well as the untold costs of lost benefits from implementing a more effective code set,” argues AHIMA. 

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