A provision in the “Doc Fix” bill passed by the U.S. House of Representatives on March 27, 2014 and approved by the U.S. Senate on March 31, 2014 included an unexpected provision changing the implementation date of ICD-10 from October 1, 2014 to October 1, 2015. Depending upon your perspective this is either good or bad news. Good news because the delay allows affected entities additional time for programming and testing updated systems. Bad news because costs will increase as states will have to pay vendors to review and rewrite work already done to ensure that ICD-9 remains in place on October 1, 2014.
The provision reads as follows:
“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 under section 1173 (c) of the 13 Social Security Act (42 U.S.C. 1320d-2(c)) and section 14 162.1002 of title 45, Code of Federal Regulations.”
October 1, 2015 is the soonest ICD-10 would be implemented, but there is nothing preventing CMS from delaying the implementation date beyond October 1, 2015. CMS opposes the delay, so odds are that if the bill passes, CMS will not further extend the implementation date.
From various news articles, those promoting the ICD-10 implementation delay are using the problems CMS experienced with rolling out the Federal Exchange as justification for the delay claiming that more time is needed for testing by the states and CMS to avoid a repeat of the Federal Exchange debacle. Opponents of the provision cite increased development costs as entities that were ready to implement in 2014 will now have to retest their systems and retrain their staff for the 2015 implementation.
The “Doc Fix” bill was crafted by House and Senate leadership crafted a short-term means for dealing with Sustainable Growth Rate (SGR) formula and an impending 24% decrease in Medicare payments to doctors on April 1.
Oddly, the AMA is the primary opposition to the “Doc Fix” bill. The AMA champions delaying the ICD-10 implementation but wants a permanent solution to the SGR and not the short-term fix proposed in the bill.
The Senate voted on the bill on Monday March 31, 2014 and passed the “Doc Fix” which included the delay in ICD-10 implementation to October 1, 2015.