News from the Week of March 28

ICD-10 Delay Passes Both Chambers

Now Heads To President’s Desk for Signature

Debate over H.R. 3402 - Sign displays the trouble with Congress

Debate over H.R. 4302 – Sign displays the trouble with Congress

The US Senate approved without amendment yesterday a House resolution to delay ICD-10 implementation, delay SGR cuts, and extend the limited moratorium on some post-payment reviews of hospital claims related to the 2-midnight rule.

H.R. 4302, entitled “Protecting Access to Medicare Act of 2014” passed by a vote of 64-35, with most well-known Republican Senators voting against it, despite the bill’s Republican authors and sponsors, and now prohibits CMS from implementing ICD-10 as planned for 2014, pushing it out at least a full year. The bill also extends the “Probe and Educate” period, now being used by CMS to handle the confusion surrounding the controversial “2-Midnight Rule,” and requiring limited post-payment review of claims subject to its provisions, in particular limiting post-payment review for patient status by Recovery Audit Contractors.

Find links to documents and text of the bills:

H.R. 4302: Protecting Access to Medicare Act of 2014

S. 2082: Two-Midnight Rule Coordination and Improvement Act of 2014


The 2-Midnight Rule Is Still In Full Effect

I mention this due to several articles that have appeared of late in various media, giving the impression that the rule is not being enforced. NOT TRUE. The delays do NOT stop enforcement, only limit current audits and auditors, in various fashions and flavors. Nevertheless, the rule as written in the 2014 IPPS Final Rule is fully in effect, and has been so, ever since October 1, 2013. Hospitals are expected to fully comply with the regulation – this despite the fact that CMS still cannot clearly define it, cannot seem to education anyone about it in an effective manner, and continues to issue differing instruction about how to audit for the rule to different parties, especially those who audit for CMS under contract. Like it or not, that is reality, today, regardless of the passage of HR 3402.


Industry Disappointed

The Way of Congress

The Way of Congress

Industry reaction to the Senate’s passage of H.R. 4302 on Monday appears to trend against the decision, with many groups expressing “deep disappointment” with the vote.

read more

Credits: Senate vote leaves ‘unanswered questions’ for ICD-10, critics say


Senate Silent, Hospitals Vocal

"I got yer DELAY, right here..."

“I got yer DELAY, right here…”

While debating the delay in ICD-10 and audits for the 2-Midnight Rule yesterday, Senators had this to say:  Not a word. Hospitals weren’t so silent.

Some reactions heard from around the country were:

  • a delay only increases the amount of resources needed
  • delay…[is] one of the worst things that can happen
  • [the delay] essentially rewinds the clock to 2012 for the healthcare industry
  • [I]t’s not clear at all that we can keep doing this at [these] price levels
  • [it] casts a cloud on the employment of more than 25,000 students [in HIT]
  • a delay likely will cost the healthcare industry an additional $1 billion to $6.6 billion on top of costs already incurred from the previous delay

See this excellent article to read the full comments and more…

Credits: In response to the Senate’s silence on ICD-10, a word about the delay


So… What Happens This Fall?

Who will get the blame for all the mess? Democrats? Republicans? Violent Video Games?

Who will get the blame for all the mess? Democrats? Republicans? Violent Video Games?

The scuttlebutt I have heard gives the impression that the Obama Administration is not happy about this bill’s passing. To be honest, I do wonder what the possibility is of a veto, but perhaps that is just too much wishful thinking.

A variety of news organizations analyzed what might happen in the fall, because of political campaigns built around the health law. See this article for those thoughts…

Credits: Assessing The Possible Impact Of Obamacare On Nov. Elections


And Are You Really Surprised by All This?

Hey I know! Let's put on a SHOW  issue a DELAY!

Hey I know! Let’s put on a SHOW issue a DELAY!

After all, everything gets delayed anyway, so why not this? It all made me think of how Mickey Rooney and Judy Garland always had the perfect solution to their problems in all their movies… “Hey, I know! Let’s put on a SHOW!” (Ok, my age is showing.)  Perhaps this is the refrain that emanates from meetings at CMS… “Hey, I know! Let’s issue a DELAY!”

Anyway… Oh, I *wish* I had written this next article I found, but I can’t claim credit — only happiness that I found it to share with my readers:

Over the past several weeks the federal government has postponed or delayed almost every major healthcare initiative save one–ICD-10.Most, if not all, of those suspensions or interruptions have hurt or will hurt healthcare providers and made their jobs harder. Isn’t it about time to provide healthcare providers a little much-needed relief?So far the federal government, be it the administration of President Barack Obama or the Congress, has yet to hit a significant deadline. Read this article for a quick laundry list of all those delays, and their impact on those who provide healthcare…

Credits: Feds Delay Everything–Why Not ICD-10?

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