The sustainable growth rate bill was recently approved by the Senate on April 14. Health care professionals had been waiting anxiously to see whether the Senate would approve the bill, as its vote would impact the formula for Medicare payments and ICD-10 implementation. Many are pleased that the bill was passed, as it will prevent any cuts to Medicare reimbursements that would have reduced payments by as much as 21 percent, according to Health Care Finance. The Senate voted 92 to 8 and President Barack Obama has agreed to sign the bill.
SGR bill prevents Medicare payment cuts
The SGR bill was passed only a few hours before health professionals would have been impacted by the Medicare payment cuts.
The policy agreement has marked a turning point for policymakers, showing that after most health care legislation has been at a standstill as a result of the Patient Protection and Affordable Care Act, advancement is finally taking place.
"Passage of this historic legislation finally brings an end to an era of uncertainty for Medicare beneficiaries and their physicians – facilitating the implementation of innovative care models that will improve care quality and lower costs," the American Medical Association's Executive Vice President and CEO James L. Madara, M.D., said in a public statement. "Patients will be able to get the care they need and deserve."
Minority Leader Nancy Pelosi and House Speaker John Boehner played major roles in the negotiation of the bill. A more effective Medicare payment formula has replaced the previous SGR equation. The new formula is set to increase these payments by as much as 0.5 percent and will take effect on July 1, 2015, and continue until 2019.
How the new SGR bill will impact ICD-10 implementation
One of the most significant outcomes that has emerged from the passing of the SGR bill is that providers can now rely on the fact that ICD-10 implementation will not be delayed again and will continue to take place on Oct. 1, 2015. The legislation did not include any comments regarding possible delays in its most recent edition, suggesting that providers should begin to prepare their staffs for the ICD-10 deadline if they have not started to already.
The bill went through the Senate without much opposition, except for eight Republicans who voted against it, including Ted Cruz, Marco Rubio, Ben Sasse, Tim Scott, David Perdue, Jeff Sessions, Mike Lee and Richard Shelby. Although lack of opposition means that any concerns of a possible ICD-10 implementation delay is unlikely, some providers are still worried that a last-minute addition to the SGR bill could push the deadline back again, as last year this is exactly what happened.
However, leaders within the health care sector, such as the American Health Information Management Association, have warned concerned providers to begin preparing for the transition to another coding set and not to focus on another delay. RevCycle Intelligence interviewed the senior director of coding policy and compliance for the AHIMA, Susan Bowman, who explained why another ICD-10 setback would hurt the industry and what the passing of the SGR legislation means for providers.
Bowman noted that the past two postponements have proven that no one will benefit from another one, even the health professionals who are rooting for one. Many physicians are now behind due to the past two postponements, as the delays encouraged them to put training and preparation on the back burner until the date is closer. Now that it is only a few months away, many practices still have preparations set aside.
Other providers who have made great efforts to ready their staffs for the new coding system are relieved at this news, as another setback would be devastating to their practices and the health care industry as a whole.