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KeyNotes Special Report: SGR and ICD-10 Legislation Update

Submitted Thursday, March 27th 2014 1:08 pm by Paul
in  keynotes  

The status of last minute legislation that would delay physician Medicare reimbursement cuts under the SGR and delay implementation of ICD-10 is fluid to say the least. Predictions concerning the likelihood of passage by the House are numerous and all over the map as concerned parties release statements and lobby congress before today's expected (or unexpected depending on who you believe) vote in the House of Representatives.

At issue in the "Protecting Access to Medicare Act of 2014" are a one-year SGR patch (the latest in a line of 17 such temporary band-aides) and an attached one-year delay in the implementation of ICD-10.

It seems no one is happy with the deal announce by House Speaker John Boehner on Wednesday. Detractors of the bill point out that only a month ago bipartisan agreement existed on a bill to permanently repeal and replace SGR, until House republicans included a provision to delay the ACA individual mandate penalties. (Ironically, the Obama administration this week proposed delaying enforcement of the individual mandate based on hardship.) Wednesday's announcement has the effect of trashing what agreement existed.

The American Medical Association, in a letter to Congress signed by over 80 various medical specialty societies said, "Instead of reforming the Medicare physician payment system, Congress seems intent on imposing yet another round of arbitrary provider payment reductions to maintain a corrosive policy that essentially every Member of Congress says should be scrapped. ...It appears that an unprecedented, bipartisan agreement on Medicare reform is on the verge of being cast aside because elected leaders are unwilling to make tough choices to strengthen programs serving 50 million Americans."

The bill is schedule for consideration today (3/27) under "suspension" rules that require a 2/3 majority agree to even consider the bill. Despite Speaker Boehner's Wednesday announcement, the likelihood of passage is increasingly unpredictable. Still, some industry observers predict passage by both the House and Senate, where the bill has the support of majority leader Harry Reid.

At stake for healthcare providers, the medical insurance industry, and clinical documentation vendors are millions of dollars and uncounted hours invested in 1CD-10 education and preparation. The Centers for Medicare & Medicaid Services has repeatedly said there will be no further de

lays in ICD-10 implementation and providers and healthcare IT companies have taken the pronouncements seriously, committing significant resources to be ready for the October 1, 2014 go live. The opportunity cost of delaying ICD-10 implementation is staggering.

Watch your inbox for KeyNotes updates regarding this important issue.

P.S. While we were preparing this article for publication the House completed debate on the bill, postponing a vote, which may suggest there is doubt about whether there are sufficient votes for passage.    

P.P.S.  This just in... Our sources on Capitol Hil

l have informed us House GOP Leadership is meeting with the Republican Doctor's Caucus to discuss an alternative pathway forward on SGR.  Looks like the bill didn't have the votes.

Yeeeesh.

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