House and Senate Vote to Pass H.R. 4302 - Patch SGR and Delay ICD-10

House and Senate Vote to Pass H.R. 4302 - Patch SGR and Delay ICD-10

By Dodge Communications (not verified) on April 1st, 2014

What does this bill mean for the healthcare IT industry? A lot. If President Obama signs the bill into law as he is expected to, ICD-10 will be delayed for at least one full year to October 1, 2015. And that’s not all: enforcement of the Medicare two-midnight payment rule will also be delayed. Prior to this delay, the industry has been working hard to switch over to the ICD-10 code set by October 1, 2014.

The bill, commonly known as the “doc fix” or SGR patch, contains these two provisions buried within the 123-page document. The legislation was controversially passed by the House of Representatives on Thursday, March 27, in what some have called a “House of Cards” move by certain representatives. The Senate vote came in on the evening of Monday, March 31 with a count of 64 – 35. The bill is the 17th SGR patch passed by Congress in the past 11 years.

Industry stakeholders rallied on both sides of the argument, with many vocal opponents. AHIMA has publicly denounced the bill, saying that another ICD-10 delay “could cost the industry an additional $1 billion to  $6.6 billion on top of costs already incurred from the previous one-year delay.”

The ICD-10 delay was not a focus during the Senate or House debates on the bill. Congress was racing against a deadline of March 31 to either patch or completely reform the SGR. Without a solution, Medicare providers would have taken a 24 percent cut in reimbursements starting on April 1. Along with the delay to ICD-10 and the Medicare two-midnight rule enforcement extension, H.R. 4302 provides physicians with a 0.5 percent payment update through the end of 2014. A zero percent payment update will be in place from January 1, 2015 through March 31, 2015.

This newest change in healthcare regulations has put many stakeholders into yet another period of uncertainty. Many providers—both hospitals and individual physician practices—have already made steep investments in the ICD-10 transitions and were prepared to meet the 2014 deadline. Healthcare IT vendors are re-evaluating their strategies and support programs for customers. Additionally, a crop of new medical coders being trained in the updated code set may not be able to secure employment for many more months.

The bill is on its way to President Obama for his signature. He is expected to sign it before the scheduled cuts go into effect.