The temporary Sustainable Growth Rate (SGR) "doc fix" bill cooked up by House Speaker John Boehner (R-Ohio) and Senate Leader Harry Reid (D-Nevada) is no slam dunk, according to a media report from Politico.
The bill would provide a one year delay to the implementation of ICD-10. Thus far, it has been met with resistance from several advocacy groups including the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME), the Chicago-based American Medical Association (AMA), and the Chicago-based American Health Information Managers Association (AHIMA).
The report from Politico states that Finance Committee Chairman Ron Wyden (D-Oregon) is aiming to get a long-term solution worked out. Since many of the advocacy groups like the AMA are pushing for that, the website says “rank and file” Republicans are not as certain about the temporary patch being passed. However, a Republican aide told the website a long-term fix was not going to happen.
As of Wednesday evening, D.C. policy sources told Healthcare Informatics that the bill was likely to pass the U.S. House on Thursday and the U.S. Senate on Friday.
The bill, which was released late Tuesday, would provide a 12-month delay to the March 31, 2014 expiration date of the SGR "doc fix.” The SGR is the formula for physician payment established under Medicare since 1997 and has been repeatedly "fixed" in order to avert physician payment cuts under Medicare.
The formula attempts to control growth in Medicare spending on physician fees by tying reimbursement to economic growth. Unfortunately, because of the yearly "fixes" since 1997, the amount the federal government in effect owes itself has grown to somewhere between $150 billion and $250 billion, a staggering sum that, legally, must be resolved.
Included in the bill is a delay to ICD-10, the new coding standard that is mandatory for compliance by Oct. 1, 2014. Many in the industry are opposed to delaying it again.
Russ Branzell, CEO of CHIME, told Healthcare Informatics, “Obviously, as we stated weeks ago, we are not for an ICD-10 delay at this point. Many of our members are concerned about software delivery and readiness, but this is nothing like concerns over meaningful use Stage 3. And in many cases, this could cause damage, because they’ve already prepared for dual coding, and have hired trainers for this. This is way too late in the process to create a delay.”
In a blog, AHIMA has called on its members to call their Congress members to ask them to take the ICD-10 provision out of the SGR bill. The advocacy group says that the Centers for Medicare and Medicaid (CMS) estimates another delay would cost $1 billion to $6.6 billion.
The AMA, which has been opposed to the ICD-10 transition in the past, is adamantly against the bill as well, as the group likely considers the SGR a more pressing issue. “By extending the Medicare provider sequester and ‘cherry picking’ a number of cost savings provisions included in the bipartisan, bicameral framework, the Protecting Access to Medicare Act actually undermines future passage of the permanent repeal framework,” AMA President Ardis Dee Hoven, MD, said in a statement Wednesday.
Healthcare Informatics will have more on this developing story.