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Washington Debrief: Senate Bill Tries to Make ICD-10 Implementation Illegal

May 28, 2013
by Jeff Smith, Director of Public Policy at CHIME
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Jeff Smith, Director of Public Policy at CHIME

US Providers at ‘Tipping Point’ in EHR adoption Over 80 percent of eligible hospitals (EHs) and more than 50 percent of eligible professionals (EPs) have adopted electronic health records (EHRs), HHS announced this week.  According to Department data, more than 291,000 EPs and more than 3,800 EHs have gotten incentive payments from Medicare and Medicaid.  HHS Secretary Sebelius said that US providers have reached a “tipping point in adoption of electronic health records.”  Provider adoption of EHRs took a dramatic upswing beginning in September 2011 for EHs and December 2011 for EPs, representing a staggering 700 percent increase for EPs and 650 percent increase for hospitals during this time.  While these gains are impressive, there is a discrepancy between the amount of providers paid incentives and the amount who have successfully met Meaningful Use.  According to the latest data available, December 2012, roughly 42 percent of EHs had attested for Stage 1 Meaningful Use.  EP data from a CMS presentation given in May suggests that EP Meaningful Users is also just above 40 percent. 

Senate Bill Looks to Make ICD-10 Implementation Illegal Three Republicans in the Senate have introduced a companion bill to a House of Representatives bill that would prohibit the Secretary of Health and Human Services from replacing ICD-9 with ICD-10 in implementing the HIPAA code set standards.  The Cutting Costly Codes Act of 2013, known as H.R.1701 in the House, was introduced by Senator Tom Coburn (R-Okla.) and cosponsored by three fellow physicians: optometrist John Boozman (R-Ark.) orthopedic surgeon John Barrasso (R-Wyo.) and ophthalmologist Rand Paul (R-Ky.).  In a “white paper,” released last year entitled ICD-10 Implementation Date: Better Never Than Later?  Sen. Coburn dismisses many of the refuted claims about how ICD-10 will benefit the health system – resulting in only redundant codes, unnecessary intricacies, high costs, wasted time, esoteric benefits, etc.  The paper calls on HHS to delay ICD-10 indefinitely, “until more meaningful changes are made to lower costs and reduce administrative costs.”  Current rules mandate ICD-10 compliance by October 2014.

CHIME is on record as supporting the current timeframes for implementing ICD-10 and is engaged with lawmakers in Washington to help educate them on the benefits of modernizing diagnosis and procedure code sets.

CIO Tells Capitol Hill Audience, More Time Needed for Stage 2 As a panelist during a recent briefing sponsored by the Committee on Telehealth and Healthcare Informatics, Lifespan CIO and Senior Vice President Carol Cotter related her organization’s experience with current time lines for Meaningful Use, particularly the impact of challenges posed by its legacy system.  Rhode Island-based Lifespan with 1,600 affiliated physicians and 1,155 licensed Beds achieved Stage 1 of Meaningful Use in FY2011 on its legacy system platform.  Cotter described an instance where a clinician found a bug that caused a medication error, using their Stage 1 certified software.  It was determined that the bug had been in the code since implementation and that nine months of records could have encountered the error.  Fortunately, no patients were harmed, but Lifespan became concerned the current platform would be insufficient for meeting Stage 2 in 2014.  To mitigate this concern, a new EHR vendor has been selected, but the install will not be completed until well into 2015.  “This completion date,” noted Cotter, “would affect Lifespan’s ability to meet Stage 2 and why I believe CHIME’s proposal to extend the timing for Stage 2 makes a lot of sense.”

On May 6, CHIME wrote to the six Senate authors of “REBOOT: Re-examining the Strategies Needed to Successfully Adopt Health IT,” that an additional year was needed. Said the letter, “A year extension of Stage 2 will give providers the opportunity to optimize their EHR technology and achieve the benefits of Stage 1 and Stage 2; it will give vendors the time needed to prepare, develop and deliver needed technology to correspond with Stage 3.”

For Cotter’s presentation and other briefing slides from the session, entitled, "Evolving Federal Regulatory Requirements Pertaining to Anti-Kickback, Self Referral Provisions, Privacy & Security, and FDA Approval," click here.