GAO: CMS is ready for ICD-10

The Centers for Medicare & Medicaid Services (CMS) is well-prepared for the switch to ICD-10 on Oct. 1, having made all the necessary changes to the Medicare payment systems, conducting testing and offering a range of programs helping the entire healthcare industry prepare for the transition, according to a report frm the U.S. Government Accountability Office (GAO).

“As demonstrated by this report, the provider outreach and responsiveness to stakeholder concerns from CMS have kept the agency on track to upgrade to the next level of healthcare coding,” said Senate Finance Committee Chairman Orrin Hatch (R-Utah) in a release. “While additional testing will be needed to ensure its success, the transition to the new system will streamline the management of healthcare records and improve patient care. I will continue to keep a close eye on this issue but see no reason for any delay past the October deadline.”

“ICD-10 codes will provide more specific information about patients, which will allow payers to more accurately reimburse providers and improve the quality of care provided to patients. CMS has taken unprecedented actions to help providers prepare for this change.  We will continue to monitor the testing CMS is conducting as we near the October 1 implementation date,” Ranking Member Ron Wyden (D-Ore.) said.

According to stakeholders interviewed by the GAO, previous implementation delays have been costly and burdensome. CMS has estimated that a one-year delay would increase the costs for some providers and payers by as much as $6 billion. In addition, both Medicare and Medicaid have incurred millions of dollars in cost because of the delay, according to the report.

CMS reported to GAO that the agency has completed all ICD-10 related changes to its Medicare payment systems and that Medicaid agencies have reported they are ready for the change. According to the report, CMS documentation shows that testing to date has not identified any CMS-related issues and that additional testing will continue up to the date of implementation. GAO said that CMS has taken action to help prepare stakeholders for the move to ICD-10, including in-person training sessions, teleconferences, educational materials and monitoring the readiness of providers and payers. Many of the tools that CMS has developed are specifically geared towards small and rural providers.  

The Coalition for ICD-10 issued a statement about the report. “Today’s report by the Government Accountability Office affirms widespread recognition across the healthcare industry that CMS is well-prepared to implement the U.S. transition to ICD-10 on October 1, 2015, and that the agency has undertaken extensive efforts to help the healthcare industry prepare. Coalition members are working together and with CMS to ensure a smooth and successful transition for all healthcare stakeholders. Our members are engaging in significant efforts to identify and educate those in need of implementation assistance through payer-provider collaboratives, training and outreach initiatives, and programs to help coders continue to achieve complete and accurate coding. We welcome the GAO report and support its findings. The U.S. is ready to move forward with ICD-10 with no further delays.”

At the Committee’s request, GAO will be continuing to monitor preparations and testing of ICD-10 implementation efforts by CMS to ensure that the system is ready for the Oct. 1 deadline.