Tags: icd-10 | delay | doc | fix | approve | congress

ICD-10 Delay Approved by Congress as Short-Term 'Doc Fix'

Tuesday, 01 Apr 2014 08:10 AM

By Michael Mullins

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The ICD-10 delay or "doc fix" bill received final congressional approval Monday, averting a 24-percent pay cut for physicians who accept Medicare insurance. The bill delays the ICD-10 compliance date to October 1, 2015.

The measure was approved with a 64 to 35 vote in the Democratic-led Senate on Monday, after the Republican-led House had approved the bill last week. It marked the 17th time Congress agreed to a temporary "doc fix" rather than agree to a permanent bipartisan replacement of the 1997 funding formula, Reuters reported.

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The problem arose from a 1997 congressional act that tied Medicare payment increases to economic growth, leaving a shortfall for doctors as healthcare costs outpaced the economy. Some in the medical community have long argued for a permanent repeal of the 1997 Medicare sustainable growth rate (SGR) payment formula.

If not approved, the 24-percent pay cut would likely lead to doctors dropping out of the Medicare program, which is primarily used by the elderly and disabled. There are approximately 51 million people in the United States who are eligible for the insurance.

Aside from the pay cut, the adoption of the ICD-10 coding system would lead to an increase from about 18,000 to about 155,000 medical code entries for various diagnoses, the Heritage Foundation noted. Many doctors fear such an increase would further limit the time they can give to a patient, considering doctors already spend about 22 percent of their time on non-clinical paperwork.

Monday's bill also provides a 0.5 percent Medicare pay bump over that 12-month period and funds a program designed to discourage the overuse of diagnostic tests and treatments, while authorizing a multistate pilot program aimed at raising standards for mental health services and improve integration of care, MedPageToday.com reported.

"A one-year delay provides welcome breathing room for some organizations coping with ongoing financial pressures and concurrent 2014 regulatory mandates—including complying with provisions of the Affordable Care Act and attestation for Stage 2 Meaningful Use," Mike Nolte, chief operating officer at the healthcare performance improvement company MedAssets said in response to Monday's Congressional vote, Global News Wire reported.

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