Newest ICD-10 bill seeks 18-month grace period, but no delay

 - Congress, House, Senate

The latest legislative activity around ICD-10 implementation does not aim to stop or delay the transition to the a newer version of the codes, but would put in place more rigorous testing and an 18-month grace period after the Oct. 1 deadline.

H.R. 2247, the Increasing Clarity for Doctors by Transitioning Effectively Now Act (ICD-TEN Act), was introduced in the House of Representatives by Rep. Diane Black (R-Tenn.). The bill would help protect companies from being penalized for routine mistakes that result from the code switch.

ICD-TEN Act also would require HHS to conduct “transparent,” “comprehensive” end-to-end testing to ensure the nation's reimbursement infrastructure is functioning properly, and that end-to-end testing would have to be made available to each vendor participating in the Medicare fee-for-service program.

“During the ICD-10 transition period, it is essential for CMS to ensure a fully functioning payment system and institute safeguards that prevent physicians and hospitals from being unfairly penalized due to coding errors,” Black said in a letter to her fellow legislators. “Reimbursement could be significantly delayed due to simple mistakes in classifying one of ICD-10s thousands of sub-codes. The effects of the change could be overwhelming, particularly for smaller provider offices with fewer resources.”

CMS has already been conducting its own ICD-10 testing throughout the year, which is one reason why the American Health Information Management Association (AHIMA) said on its website that it does not support the ICD-TEN Act and thinks CMS has shown it is prepared for the Oct. 1 deadline.

Black’s bill comes on the heels of H.R. 2126, the Cutting Costly Codes Act of 2015, which was introduced by Rep. Ted Poe (R-Texas) and co-sponsored by six other republican representatives. That bill aims to stop ICD-10 implementation at the gate.

“The new ICD-10 codes will not make one patient healthier,” Poe said in a statement when that bill was first introduced. “What it will do is put an unnecessary strain on the medical community who should be focused on treating patients, not implementing a whole new bureaucratic language. Instead of hiring one more doctor or nurse to help patients, medical practices are having to spend tens of thousands just to hire a specialist who understands the new codes.”

James Madara, the executive vice president and CEO of the American Medical Association (AMA), wrote a letter last week in support of Poe’s bill, saying the timing of ICD-10 implementation “could not be worse” and that physicians were “overwhelmed.”