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BREAKING NEWS: ‘Doc Fix’/ICD-10 Bill Passes U.S. Senate

March 31, 2014
by Rajiv Leventhal and Mark Hagland
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Presidential approval is expected next, which would confirm the one-year delay

On Monday, March 31, the U.S. Senate passed another temporary Sustainable Growth Rate (SGR) "doc fix" bill, hours before automatic, 24-percent Medicare physician payment cuts would have gone into effect. The bill will now be sent to President Barack Obama, who can either veto it or sign it into law. Sources have told Healthcare Informatics that Presidential approval is expected. The bill passed by a vote of 64-35, with bipartisan support, as well as some bipartisan opposition.

The Senate vote comes four days after the U.S. House of Representatives passed the one-year delay with its vote last Thursday afternoon. Released last week, the bill provides a 12-month delay to the March 31, 2014 expiration date of the SGR "doc fix.” The SGR, or sustainable growth rate formula, is the formula for physician payment established under Medicare since 1997, and has only been deployed a single year, with Congress authorizing annual "fixes" in its place.

The bill just passed by both houses of Congress also includes a one-year delay in the mandatory transition to the ICD-10 coding system, which was supposed to take effect on October 1 of this year. According to some sources, the language concerning the ICD-10 element of the SGR patch was created at the behest of a coalition of specialty medical societies under what is called a re-valued code provision.

Groups such as the Chicago-based American Medical Association, which has been down on the ICD-10 transition before, are overwhelmingly against another temporary fix to the SGR. Since the bill was announced, AMA has been actively attempting to get its members to overturn the temporary pay patch.

Additionally, the Chicago-based American Health Information Management Association (AHIMA) held a “virtual rally” against another ICD-10 compliance delay on Twitter. AHIMA has estimated that the delay could cost the industry between $1 billion and $6 billion.

Another industry group, the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME), also made its stance clear when its president and CEO, Russell P. Branzell, told HCI last week that it is way too late in the ICD-10 process to create a delay.

So while these organizations can’t be too thrilled with the results of today’s vote, not everyone in the industry is down on another delay. The Medical Group Management Association (MGMA), for one, recently laid out some of the positives to another delay to the compliance date of the coding system. Rob Tennant, senior policy adviser for MGMA, said that “a thousand different cogs that have to work smoothly” in order for ICD-10 to run and that many of those “cogs” are not ready. But for the most part, the bill has not been well received by healthcare advocacy groups.



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