CHIME official 'not optimistic' about SGR/ICD-10 Senate vote

Reaction to Thursday's voice vote by the House to approve a temporary, one-year fix to the sustainable growth rate--as well as a delay of at least one year on ICD-10 implementation--has been mixed from both industry groups and legislators. The Senate is expected to vote Monday on the legislation.

Jeff Smith, director of federal relations for the College of Healthcare Information Management Executives--which opposes a delay--told FierceHealthIT in a phone conversation that he thought the outcome caught a lot of people off guard, particularly in light of the fact that the issue of ICD-10 and the looming regulatory deadline has been fought rather publicly by several physician groups, which have had a strong constituency in the republican doctor's caucus in the House.

"The ICD-10 deadline has been a fairly visible--albeit archaic--conversation in Congress for a while," Smith said. "But there was very little conversation about getting an ICD-10 delay into either the current SGR doc-fix path or a permanent repeal. That certainly was not very visible."

Smith said he's not optimistic that the ICD-10 language in the bill will be dropped or truncated by the Senate.

"The prevailing chatter right now is that this was inserted as a way to appease some of the doc groups that are going to see a reduction in their reimbursement," Smith said. "I don't know that there exists enough political pressure behind the scenes to make this go away."

Robert Tennant, senior policy advisor at the Medical Group Management Association, told EHRIntelligence that while MGMA opposes the bill because the group instead favors a permanent SGR fix, it does not necessarily oppose the ICD-10 delay within the legislation.

"Right now, our indications are that the key trading partners of practices aren't ready," Tennant said. "Software vendors, both of the practice management systems and the EHRs, aren't ready. Health plans are simply not in the position to be able to do full end-to-end testing with physician practices or with Medicare."

Additionally, Tennant told Health Data Management that he could not see either the Senate or President Obama holding up passage of the bill. "Everyone realizes there are bigger issues here," he said. "And the issues are that an SGR fix is needed before April 1 to avoid payment cuts, and mid-term elections loom."

Despite the shared opinion by Smith and Tennant on the bill's chances of passing through the Senate, Rep. Jim McDermott (D-Wash.) told Politico that he doubts the patch will survive the vote.

The American Health Information Management Association said it was "extremely disappointed" by the outcome, calling continued reliance on ICD-9 "not a viable option" for public health safety.

"The healthcare industry has had an abundance of time to prepare for the transition to ICD-10," an AHIMA statement said. "Many hospitals, healthcare systems, third-party payers and physicians' offices have prepared in good faith and made enormous investments to be ready for the Oct. 1, 2014, deadline and the transition to ICD-10."

Tom Leary, vice president of government relations at HIMSS, said in a statement that either way the vote goes, his organization will support its members "by providing education, resources and tools to help them make the conversion to ICD-10 in the most effective and efficient ways."

Should the patch pass and be signed into law, Smith said it essentially be like going into a time warp. 

"Essentially, we'd find ourselves back in 2013 again, or even 2012, where doctors are still getting a short-term patch, where ICD-10 gets pushed back another year, and it's not at all clear that we can keep doing this at the price levels," he said.

To learn more:
- check out the Senate floor schedule for Monday
- here's the EHRIntelligence article
- read the Health Data Management story
- check out the Politico piece
- here's the AHIMA statement
- here's the HIMSS statement

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