Home Health & Hospice Week

Lawmakers override CMS’s wishes on ICD-10.

After repeated assertions from the Centers for Medicare & Medicaid Services that ICD-10 would proceed on pace, how did a surprise ICD-10 delay materialize?

With the March 31 expiration of a delay to a pending physician pay cut staring Congress in the face, lawmakers on March 27 introduced the Protecting Access to Medicare Act of 2014. This bill halted the planned 24 percent pay cut for the rest of the year. However, the temporary doc fix wasn’t the only feature of the legislation. It also the ICD-10 delay.

Mentioned about one-third of the way into the 121-page bill is a short paragraph that states, “The Secretary of Health and Human Services may not, prior to October 1, 2015, adopt ICD-10 code sets as the standard for code sets.”

Needless to say, professional organizations disagreed strongly with the bill. “AHIMA officials have said that another delay in ICD-10 will cost the industry money and wasted time implementing the new code set,” the American Health Information Management Association said in a March 27 statement.

Even the American Medical Association — which has long advocated for an ICD-10 delay — urged Congress to vote “no” on the bill, although the AMA’s opposition was more focused on the financial provisions. “Full repeal of the sustainable growth rate formula is the answer to strengthening the Medicare program, not another patch,” AMA president Ardis Dee Hoven said in a March 26 statement.

Insiders say CMS itself is not supportive of the change either.

Despite the pushback, the House of Representatives approved the bill. On March 31, the Senate followed suit, and President Obama signed the bill into law on April 1.