CMS Chief Tavenner: No Delay for ICD-10, but Some Meaningful Use Relief

CMS Chief Tavenner: No Delay for ICD-10, but Some Meaningful Use Relief

Friday, February 28, 2014  iHealth Beat

At the Healthcare Information and Management Systems Society's annual conference on Thursday, CMS Administrator Marilyn Tavenner said that there will be no further delays to ICD-10 but that the agency would offer more flexibility in hardship exemptions for Stage 2 of the meaningful use program, Clinical Innovation & Technology reports.

Tavenner's Comments on the Meaningful Use Program

Under the 2009 federal economic stimulus package, health care providers that demonstrate meaningful use of certified electronic health record systems can qualify for Medicaid and Medicare incentive payments (Walsh, Clinical Innovation & Technology, 2/27)

Earlier this week, a large coalition of provider organization sent a letter asking HHS Secretary Kathleen Sebelius to delay the timeline of the meaningful use program (Ackerman, iHealthBeat, 2/25).

Although the federal government has not acted on the groups' request, Tavenner said during her keynote speech that CMS would be more flexible with its hardship exemptions and would consider such applications on a case-by-case basis (Clinical Innovation & Technology, 2/27).

Currently, CMS offers hardship exemptions for new providers, those facing natural disasters and those who do not have face-to-face interaction with patients (Pittman, MedPage Today, 2/27).

Tavenner noted that some health care providers might be facing other issues that prevent them from meeting Stage 2, such as not having tested and certified EHR software or EHR vendors going out of business.

Tavenner stressed the importance of moving forward with the meaningful use program.

She said that interoperability requirements of Stage 2 of the program are "a key step to everything going forward," especially value-based payment programs. She added, "Now is the time for us to start moving forward" (Conn, Modern Healthcare, 2/27).

Officials said more specific details on the hardship exemptions would be available in early March (MedPage Today, 2/27). 

Tavenner's Comments on ICD-10

Addressing the upcoming ICD-10 deadline, Tavenner said, "Now is not the time for us to stop moving forward" (Weiner, HealthLeaders Media, 2/27). She added, "Let's face it ... We've delayed this several times, and it's time to move on" (Modern Healthcare, 2/27). "There will be no change in the deadline for ICD-10," she said (HealthLeaders Media, 2/27).    

U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures. The switch from ICD-9 to ICD-10 code sets means that health care providers and insurers will have to change out about 14,000 codes for about 69,000 codes.

In August 2012, HHS released a final rule that officially delayed the ICD-10 compliance date from Oct. 1, 2013, to Oct. 1, 2014, partially to look at the incremental changes needed in reforming health care (iHealthBeat, 2/20).

According to Healthcare Informatics, Tavenner also highlighted several steps that CMS is taking to support ICD-10 testing, such as its recent decision to conduct end-to-end testing (Perna/Hagland,Healthcare Informatics, 2/27).

Reaction

Shortly after Tavenner's speech, the College of Healthcare Information Management Executivesissued a release on the hardship flexibility, saying, "Such relief is vitally important for the future success of Meaningful Use, as ICD-10 deadlines and continued shifts in payment policies demand an ever-increasing amount of IT and workforce resources." However, the group noted, "Should CMS choose to define the new hardship exemptions in a way that does not address the core concerns of our industry, we will continue to see the kind of flexibility that nearly 50 national health care organizations communicated" this week (Clinical Innovation & Technology, 2/27).

Chantal Worzala, director of policy at the American Hospital Association, in a statement said AHA "is disappointed that CMS will not make changes to the timelines or provide additional flexibility in the meaningful use requirements." Worzala added, "The AHA will work closely with the agency to ensure that the hardship exceptions protect hospitals from unwarranted penalties."

Meanwhile, American Medical Association President Ardis Dee Hoven raised concerns about CMS' lack of a "back-up plan" for ICD-10 testing, in the event that "last-minute testing demonstrates anticipated problems with this massive coding transition." He said, "At the end of the day, sticking hard and fast to the ICD-10 deadline without a back-up plan to address disruptions in medical claims processing will hurt doctors and their patients" (Modern Healthcare, 2/27).