Disappointment, confusion and praise follow Senate passage of SGR patch, ICD-10 delay

Just a few weeks ago, Centers for Medicare & Medicaid Services (CMS) Administrator Marilynn Tavenner’s resounding message at the Health Information and Management Systems Society annual conference in Orlando was that more ICD-10 delays were not going to happen.

But with the Senate’s passage on Monday of the Protecting Access to Medicare Act of 2014, a one-year sustainable growth rate (SGR) patch that includes a provision delaying ICD-10 for another year, sharp disappointment, confusion and a few cheers rippled through the industry. The bill also includes investments on quality performance and improvement.

Following the Monday vote, the American Health Information Management Association (AHIMA) expressed “deep disappointment” in the bill’s passage. “It has been estimated that another one-year delay of ICD-10 would likely cost the industry an additional $1 billion to $6.6 billion on top of the already incurred costs from the previous one-year delay,” according to AHIMA’s statement. “This does not include the lost opportunity costs of failing to move to a more effective code set.”

The association is seeking clarification on the delay, including its exact length as the provision’s language states that ICD-10 will be delayed “until at least” Oct. 1, 2015.  

College of Healthcare Information Management Executives (CHIME) similarly expressed disappointment and sought clarity on what the delay means for providers, vendors, clearinghouses and others in the industry. “The delay leaves numerous unanswered questions from testing, training and revamping the agency’s education resources, such as the CMS eHealth University, designed to help providers understand, implement and successfully participate in the conversion process," according to CHIME's statement.

American Medical Association (AMA) President Aris Dee Hoven, MD said in a statement that AMA was “deeply disappointed” in the SGR patch. “Congress has spent more taxpayer money on temporary patches than it would cost to solve the problem for good. This bill perpetuates an environment of uncertainty for physicians, making it harder for them to implement new innovative systems to better coordinate care and improve quality of care for patients,” he said.

Workgroup for Electronic Data Interchange (WEDI) said the bill’s passage offers more time for the industry to plan for the ICD-10 transition. “The additional time provides an opportunity for the healthcare industry to assess key challenges to implementing ICD-10 and to develop industry consensus on how to best overcome such challenges,” according to a statement. WEDI said it will address the delay at its upcoming annual conference in Los Angeles.

As the bill contains provisions supporting quality improvement, the National Quality Forum (NQF) lauded its passage. “We urge Congress to continue their work on comprehensive Medicare physician payment reform that rewards quality, while thanking them for their consistent, ongoing support of NQF,” said Christine K. Cassel, MD, president and CEO at NQF, in a statement. "We look forward to continuing NQF's work on quality measurement endorsement and improvement that is needed to move us closer to a truly value based healthcare system."