Small reprieve for Stage 2 deadline, but not ICD-10

Hopes raised by several speakers at last week's Healthcare Information and Management Systems Society annual meeting in Orlando, Fla., for a government reprieve from two pending technology deadlines were dashed by CMS Administrator Marilyn Tavenner.

No extension will be given on the Oct. 1 deadline to adopt the ICD-10 family of diagnostic and procedural codes. “We've delayed this several times and it's time to move on,” Tavenner said.

For the other hoped-for reprieve, concerning Stage 2 of the federal electronic health-record incentive payment program, which is already underway, Tavenner raised only the possibility of some hardship exceptions from compliance.

While some industry leaders and health information technology cognoscenti applauded Tavenner's pronouncement, others were unhappy that the CMS offered only a modicum of relief for an industry overwhelmed by two concurrent major federal initiatives.

Those critics cited problems with deliveries of IT systems upgraded for both ICD-10 and Stage 2.

“I was certainly happy to see them sticking to that (ICD-10) date and it will certainly push the industry to meet that deadline,” said Stanley Nachimson, a Baltimore health IT consultant and co-author of a recent report on ICD-10 costs and readiness.

“It's good news they announced the end-to-end testing. They're taking all the right steps,” he said.

Nachimson's report, sponsored by the American Medical Association, said many EHR vendors plan to release ICD-10-updated software in the first quarter of this year, but won't have 2014-edition software for Stage 2 until this summer.

The American Medical Association, which has repeatedly called for delays to ICD-10, was disappointed. Many physicians are still waiting for their vendors to deliver software with ICD-10 updates, said AMA President Dr. Ardis Dee Hoven.

“The later physicians receive this software, the harder it will become to test it” before Oct. 1, she said. “The slightest glitch in the ICD-10 rollout could potentially cause a billion-dollar backlog of medical claims that jeopardizes physician practices and disrupts patients' access to care.”

Tavenner's hardship exemption for Stage 2 “could be an avenue to provide some relief for some hospitals,” said Samantha Burch, vice president for legislation and health information technology with the Federation of American Hospitals.

And while the FAH isn't taking a particular position on Tavenner's ICD-10 remarks, the two mandates are intertwined, she said.

“It's not ICD-10 in one bucket and meaningful use in another,” Burch said. “It's really a portfolio of requirements that are taking the same resources.”

The American Hospital Association's director of policy, Chantal Worzala, also was silent on ICD-10.

But she said the AHA “is disappointed that the CMS will not make changes to the timelines or provide additional flexibility in the meaningful-use requirements.”

Robert Tennant, senior policy adviser for the Medical Group Management Association, said he was happy for flexibility with Stage 2, but said there are similar problems with ICD-10.

“Just like meaningful use, there are folks who just can't move ahead,” he said. “If you're not moving ahead with ICD-10, you get a 100% penalty.”

In March, the CMS will begin its first round of testing on Medicare claims processors' systems for ICD-10 readiness, with more robust “end-to-end” testing scheduled for this summer.

Follow Joseph Conn on Twitter: @MHJConn