Monday evening, the U.S. Senate managed to create an uproar in the healthcare community by passing a bill patching Medicare's pay rate for doctors instead of repealing it and delaying the ICD-10 compliance deadline.
Senators voted 64 to 35 to pass the Protecting Access to Medicare Act of 2014, which delays the Medicare physician pay cut until April 1, 2015 and pushes back the ICD-10 compliance deadline by a year, to Oct. 1, 2015. In order to take effect, the bill still needs to be signed President Barack Obama.
Senators and observers of the legislative action acknowledged the bill was flawed.
"We need to restore sanity to the Medicare payment system," said Senate Majority Leader Harry Reid (D-Nev.) at the beginning of the debate yesterday. "The fact remains, this legislation is not perfect; it's not ideal."
However, lawmakers could not come to an agreement on what a permanent fix to Medicare's Sustainable Growth Rate should be, he said. "I hope it's our last patch."
Doctors' groups were largely unsupportive of the bill, which averted a pay cut for the 17th time instead of repealing the SGR. Physicians have long argued for a repeal and, until recently, believed that this could be the year a repeal may have actually happened.
However, their hopes were killed by the vote yesterday, and they were immediately vocal about their displeasure.
"The American Medical Association is deeply disappointed by the Senate's decision to enact a 17th patch to fix the flawed Sustainable Growth Rate (SGR) formula. Congress has spent more taxpayer money on temporary patches than it would cost to solve the problem for good," said Ardis Dee Hoven, MD, the AMA's president, in a statement.
"Lawmakers have walked away from efforts to pass meaningful payment reform legislation that includes permanent repeal of the SGR formula," said David W. Parke II, MD, CEO of the American Academy of Ophthalmology, in a statement. "Instead, Congress has chosen a fiscally irresponsible $20 billion short-term solution, taking away funding mechanisms that could have been used to offset the cost of permanent SGR repeal."
While the focus and debate yesterday was largely about the SGR, the provision delaying the ICD-10 implementation is garnering a mixed reaction.
Joe Lavelle, founder of Results First Consulting, which works with healthcare systems, said that his health insurer and health system clients would have been ready by Oct. 1, 2014 but will take advantage of the extra year by using it for testing and dual-coding.
However, the delay will be costly he said. Lavelle estimated that the delay will cost his clients anywhere from $500,000 to $3 million each, depending primarily on the organization's size.
"If we simply delay without addressing the reasons for delay (procrastination, lack of testing, etc)," Lavelle said, "then we will be back in the same place next year."
This story is based on a post appearing on Government Health IT.