ICD-10 Transition: A Stick in the Legislative Hornet's Nest

There is one certainty in the current political environment, attempts at change in health care will likely invoke a flurry of legislative responses that trade in the language of government overreach or bureaucrats wrongly telling health care how to best to do its job. The approaching October ICD-10 transition deadline has acted like a stick in the legislative hornet’s nest in Washington with a handful of lesser-known Republican lawmakers attempting to make political hay out of ICD-10. Two such bills are active in the House of Representatives and should be monitored and well understood by any practices utilizing EHR.

ICD-TEN Act

On May 12, Rep. Diane Black (R-TN-6) introduced a new bill with five Republican co-sponsors, into the US House of Representatives. H.R. 2247, the “Increasing Clarity for Doctors by Transitioning Effectively Now Act” (ICD-TEN Act), would “require the Secretary of Health and Human Services (HHS) to provide for transparent testing to assess the transition under the Medicare fee-for-service claims processing system from the ICD-9 to the ICD-10 standard, and for other purposes.”

The approaching October ICD-10 transition deadline has acted like a stick in the legislative hornet’s nest

Unlike previous legislation, the bill does not push back the October 1, 2105 compliance deadline but, rather, calls for an 18-month transition period requiring HHS to report to Congress certifying whether or not the ICD-10 transition is fully functional and not hindering the fulfillment of provider claims. The bill also proposed a safe harbor provision prohibiting the Centers for Medicare and Medicaid Services from denying claims submitted with unspecified or inaccurate subcodes.

As of June 1 the bill was referred to the Committee on Energy and Commerce, and the Committee on Ways and Means. Currently, these Committees have not placed the bill on their schedules. Govtrack.us gives this proposed legislation a 1% chance of being passed.

Cutting Costly Codes Act of 2015

Similarly, Rep. Ted Poe (R-Tex.), supported by six of his Republican colleagues, has introduced a House bill to block the government-mandated ICD-10 transition in October.

The “Cutting Costly Codes Act of 2015”, H.R. 2126 would prohibit the Secretary of Health and Human Services from requiring the medical community to comply with the ICD-10 codes. Instead, the bill would have the US Government Accountability Office conduct a study "in consultation with stakeholders in the medical community…to identify steps that can be taken to mitigate the disruption on health care providers resulting from a replacement of ICD-9 as such a standard." The 2015 iteration attempts to revive a similar bill introduced by Poe in 2013 which was presented in a previous session of Congress but was not enacted. According to Poe, an indefinite moratorium on ICD-10 should be enacted due to the transition’s perceived harm to the healthcare industry and according to Poe unnecessary requirements which in Poe’s words “will not make one patient healthier,'

This bill was assigned to a congressional committee on April 30, 2015, which will consider it before possibly sending it on to the House or Senate as a whole. Govtrack.us gives this bill a 0% chance of being passed.

Although one should never say never, these two pieces of legislation will likely never make it into law as the political will in Congress and by the President (who must sign the bill into law) to disrupt or alter the ICD-10 transition is not present.

Realistically, these are symbolic measures used to make a record of these conservative legislators’ distaste for ICD-10 implementation. As such the healthcare community would be well advised to keep an eye on such legislation as a matter of caution, but really should not lose sleep worrying if the ICD-10 transition will continue as planned in October.