Categoría: Noticias

***UPDATE

3/27/2014 11:50 a.m. CT — The US House of Representatives has passed the SGR patch bill, HR 4302, which calls for the delay of ICD-10-CM/PCS a year until October 1, 2015.  Read the full story here.  ***

A new bill has been quietly introduced into the US House and Senate that features a section calling for the delay ICD-10-CM/PCS implementation until 2015.

The bill, HR 4302 in the House and S 2157 in the Senate, which would adjust the Sustainable Growth Rate (SGR) and amend the Social Security Act to extend Medicare payments to physicians and change other provisions of the Medicare and Medicaid programs, also includes a seven line section that would delay ICD-10 to October 1, 2015.

This bill was negotiated at the leadership level in the House and Senate, and it is expected that there will be no debate before calling the bill to vote. The bill states: “The Secretary of Health and Human Services may not, prior to October 1, 2015, adopt ICD–10 code sets as the standard for code sets under section 1173(c) of the 13 Social Security Act (42 U.S.C. 1320d–2(c)) and section 14 162.1002 of title 45, Code of Federal Regulations.”

This bill is expected to go to the House floor on Thursday, March 27 for a vote.

AHIMA Calls on Members to Request Removal of Delay Provision

AHIMA has put out a call to members and other stakeholders to contact their representatives in Congress and ask them to take the ICD-10 provision out of the SGR bill.

When contacting Congressional members, AHIMA has instructed callers to state that their representatives/senators:

• Oppose the specific language in the SGR patch legislation
• Reach out to the Speaker of the House John Boehner and Senate Majority Leader Harry Reid to remove the ICD-10 language from the bill

AHIMA officials have said that another delay in ICD-10 will cost the industry money and wasted time implementing the new code set. Groups opposing ICD-10 have said that the implementation, with its large increase in codes and need to adapt healthcare systems, causes an unnecessary burden on providers.

CMS estimates that a one year delay could cost between $1 billion to $6.6 billion, according a statement from AHIMA officials. ”This is approximately 10-30 percent of what has already been invested by providers, payers, vendors and academic programs in your district,” AHIMA wrote in a statement. ”Without ICD-10, the return on investment in EHRs and health data exchange will be greatly diminished…  Let Speaker Boehner and Senate Majority Leader Reid know that a delay in ICD-10 will substantially increase total implementation costs in your district.”

Contacting Your Congressional Representatives

For more information on contacting your representatives and senators in Congress, visit AHIMA’s Advocacy and Public Policy representative look-up site at http://capwiz.com/ahima/dbq/officials/. For more information on AHIMA ICD-10 advocacy, visit http://www.ahima.org/about/advocacy.

The US House of Representatives has passed a bill that would delay the implementation of ICD-10-CM/PCS for one year. A similar bill in the Senate is expected to be voted on soon. AHIMA has called on proponents of ICD-10 to contact their senators and ask that they not delay ICD-10.

The bill, H.R. 4302 – Protecting Access to Medicare, mainly adjusts the Sustainable Growth Rate (SGR) for Medicare payments, which dictates how much physicians get paid for services. But bill section 212, a seven line section inserted into the SGR patch bill, also states that the Department of Health and Human Services (HHS) cannot implement the ICD-10 code set until October 1, 2015, a year later than the current date of October 1, 2014.

The bill introduced by Representative Joe Pitts (R-PA) states: “The Secretary of Health and Human Services may not, prior to October 1, 2015, adopt ICD–10 code sets as the standard for code sets under section 1173(c) of the 13 Social Security Act (42 U.S.C. 1320d–2(c)) and section 14 162.1002 of title 45, Code of Federal Regulations.”

House Speaker John Boehner (R-OH) and Senate Leader Harry Reid (D-NV) announced they were working in cooperation on the SGR “patch” bill late Tuesday night. The bill passes a temporary one year patch to prevent a 24 percent reduction in physician Medicare payments that would go into effect March 31. The development of the bill, and insertion of the ICD-10 delay, was negotiated at the leadership level in the House and Senate.

The bill was voted on and passed without a roll call vote, and was conducted immediately after an unexpected recess when many House representatives had not returned to the floor. The recess was taken for supporters of the bill to drum up more support. The afternoon vote took place following an objection to the vote in the absence of a quorum by Pitts Thursday morning. A quorum was not present for the afternoon vote.

Senate Set to Vote on SGR/ICD-10 Delay Bill Soon

Action on the SGR patch bill now moves to the Senate. Senators are expected to vote on a SGR patch bill in the coming days that could delay ICD-10, but a vote date has not yet been set. A similar bill, S. 2157, was introduced into the Senate which would also delay ICD-10 for one year. However, the Senate could vote on the House version of the bill, or vote on a different bill featuring larger reform of SGR; one ICD-10 proponents hope would not include an ICD-10 delay.

AHIMA and other proponents of ICD-10 have been rallying members and stakeholders to contact their senators and tell them to not delay the new code set. On Wednesday thousands of AHIMA members contacted their representatives and called for no further delays of ICD-10.

Further requests to contact senators and ask that they “pass a clean bill to fix SGR and not delay ICD-10″ have been made by AHIMA and the Coalition for ICD-10, an advocacy group of healthcare associations, vendors, and insurers that support the implementation of ICD-10. In a statement, AHIMA officials said that “physician reimbursement under Medicare should not be tied legislatively to ICD-10 implementation.”

Rollercoaster Session Ends with Delay Vote

During the House vote debate this morning, several House representatives mentioned that H.R. 4302 included provisions unrelated to SGR that likely many members of Congress were unaware were included in the bill.

“Perhaps we ought to have a criteria of everybody who has read this bill can vote on it. My bet is there would be very few members who would be able to vote on this bill,” said Democratic Whip Representative Steny H. Hoyer (D-MD). “None of us know what the substance of this bill is… I challenge any member to come up here and say ‘I have read this bill.’”

During the House floor debate Thursday morning, House Minority Leader Representative Nancy Pelosi (D-CA) characterized the rushed manner in which the bill had been brought to the floor, with most representatives having no opportunity to see the bill before a vote, as a missed opportunity. “This would be a more appropriate debate a month ago, where the clock does not run out over the weekend. But this is a tactic, it’s a technique, used by the [Republican] majority to force the hand without the proper weighing of equities in all of it,” said Pelosi.

It remains unclear why the language to delay ICD-10 implementation until October 1, 2015 was added to H.R. 4302. The ICD-10 delay section was not a point of discussion during the House floor debate. The SGR has been an ongoing issue in Congress for a number of years and a permanent solution has yet to be passed. Instead, continuous SGR patches have been employed.

After 40 minutes of debate on the bill, H.R. 4302, and an inital call for a vote, House officials decided that a quorum was not present, and therefore a vote would not be conducted. Further proceedings on the motion were postponed while bill supporters met privately with members of the House to gain support for its passing.

Though a vote could have occurred without quorum if agreed upon by House representatives, Pitts, who introduced the bill, objected to a vote in the absence of quorum. This uncommon move is likely because the bill had strong objections from groups like the American Medical Associationand members of Congress who are physicians, and bill supporters didn’t think they had enough votes, according to AHIMA’s Director of Congressional Relations Margarita Valdez, who has been monitoring congressional proceedings on ICD-10.

“This is a game unworthy of this institution and of the American people,” said Hoyer, regarding the lack of transparency in the bill’s development and rushed journey to the House floor. “It is unfortunate that we have been put in this position with less than 48 hours’ notice of what’s in this bill.”

Without formal warning, the bill was reintroduced Thursday afternoon and passed by a voice vote without quorum. The move excluded several members of the House from the vote, and made it impossible to know exactly who would have voted for or against the measure.

ICD-10 Proponents Warn of Harmful Implications of Another Delay

AHIMA officials have said that another delay in ICD-10 will cost the industry money and wasted time implementing the new code set. Groups opposing ICD-10 have said that the implementation, with its large increase in codes and need to adapt healthcare systems, causes an unnecessary burden on providers.

In a letter to Centers for Medicare and Medicaid Services Administrator Marilyn Tavenner, members of the Coalition for ICD-10 said that CMS and other government officials should move forward with the current ICD-10 deadline of October 1, 2014. Coalition representatives include the American Hospital Association (AHA), the American Medical Informatics Association (AMIA), BlueCross BlueShield Association, the College of Healthcare Information Management Executives (CHIME), and vendors like 3M Health Information Systems and Siemens Health Services.

“Although many of the signatories to this letter were at odds over the timing of implementation when the National Committee on Vital and Health Statistics (NCVHS) and HHS embraced ICD-10—which has already been adopted outside the U.S. worldwide—we are now in agreement that any further delay or deviation from the October 1, 2014 compliance date would be disruptive and costly for health care delivery innovation, payment reform, public health, and health care spending,” the letter reads. “By allowing for greater coding accuracy and specificity, ICD-10 is key to collecting the information needed to implement health care delivery innovations such as patient-centered medical homes and value-based purchasing,” the letter stated.

“Moreover, any further delays in adoption of ICD-10 in the U.S. will make it difficult to track new and emerging public health threats. The transition to ICD-10 is time sensitive because of the urgent need to keep up with tracking, identifying, and analyzing new medical services and treatments available to patients,” the letter continued. “Continued reliance on the increasingly outdated and insufficient ICD-9 coding system is not an option when considering the risk to public health.”

The impact of another delay in ICD-10 would be far reaching across the healthcare industry, AHIMA officials said. Many healthcare education programs have been teaching ICD-10 exclusively to students in preparation for the October implementation, while healthcare organizations have invested time and money into preparing staff and systems for the switch.

Groups opposing ICD-10 have said that the implementation, with its large increase in codes and need to adapt healthcare systems, causes an unnecessary burden on providers.

The call for a delay likely came as a surprise to CMS. On February 27, Tavenner announced at the Health Information and Management Systems Society Annual Conference that ICD-10 would not be delayed any further, stating “we have already delayed the adoption standard, a standard the rest of the world has adopted many years ago, and we have delayed it several times, most recently last year. There will be no change in the deadline for ICD-10.”

AHIMA Calls on Members to Request Removal of Delay Provision

AHIMA has put out a call to members and other stakeholders to contact their senators and ask them to take the ICD-10 provision out of the Senate’s version of the SGR bill.

When contacting congressional members, AHIMA has instructed callers to state that their senators should:

• Oppose the specific language in the SGR patch legislation
• Reach out to the Speaker of the House John Boehner and Senate Majority Leader Harry Reid to remove the ICD-10 language from the bill

CMS estimates that a one year delay could cost between $1 billion to $6.6 billion, according a statement from AHIMA officials. ”This is approximately 10-30 percent of what has already been invested by providers, payers, vendors and academic programs in your district,” AHIMA wrote in a statement, which it encouraged its members to use when contacting Congressional representatives. ”Without ICD-10, the return on investment in EHRs and health data exchange will be greatly diminished…  Let Senate Majority Leader Reid and Chairman [Ron] Wyden know that a delay in ICD-10 will substantially increase total implementation costs in your district.”

Contacting Your Congressional Representatives

For more information on contacting your senators in Congress, visit AHIMA’s Advocacy and Public Policy representative look-up site at http://capwiz.com/ahima/dbq/officials/.

For more information on AHIMA ICD-10 advocacy, visit http://www.ahima.org/about/advocacy.

The US Senate is scheduled to vote on a bill on Monday that includes language delaying ICD-10-CM/PCS implementation until at least October 1, 2015.

According to the United States Senate’s floor schedule, senators will “convene and begin consideration” of H.R. 4302, Protecting Access to Medicare Act of 2014, at 2 p.m. on Monday, March 31. A vote on the bill is expected to take place.

The H.R. 4302 bill, which was narrowly passed under uncommon circumstances by the US House of Representatives on Thursday, mainly adjusts the Sustainable Growth Rate (SGR) for Medicare payments, which dictates how much physicians get paid for services. But section 212, a seven line section inserted into the SGR patch bill, also states that the Department of Health and Human Services (HHS) cannot implement the ICD-10 code set until at least October 1, 2015, a year later than the current date of October 1, 2014. (For full coverage of the House vote and the impact of an ICD-10 delay on the healthcare industry, click here.)

The bill introduced by Representative Joe Pitts (R-PA) states: “The Secretary of Health and Human Services may not, prior to October 1, 2015, adopt ICD–10 code sets as the standard for code sets under section 1173(c) of the 13 Social Security Act (42 U.S.C. 1320d–2(c)) and section 14 162.1002 of title 45, Code of Federal Regulations.”

The Senate will vote on the House’s H.R. 4302 bill, and not a previously introduced Senate bill, S. 2157, which looked to enact wider reform of SGR. The Senate will conduct an “up or down” vote on the bill, which means senators would not be able to remove any sections of the bill, including the ICD-10 delay provision, before a vote. Therefore AHIMA and other proponents of ICD-10 have asked healthcare stakeholders to contact their senators and tell them to vote against H.R. 4302.

Congress is working against a deadline of March 31 to reform or patch the SGR before it directly impacts physician payment. Physician groups, including the American Medical Association, have come out against  H.R. 4302 since it does not provide a long-term solution to the SGR issue. The insertion of the ICD-10 delay section into H.R. 4302 was likely done to placate physicians who are against an SGR patch. The AMA has said they are against moving to ICD-10.

On March 26 a coalition of nearly 90 state and national medical societies issued a letter to congressional leaders saying they oppose H.R. 4302 and asked them to scrap the bill for larger reform of Medicare payments.

AHIMA: Delay Will Waste Money and Time

AHIMA officials have said that another delay in ICD-10 will cost the industry money and wasted time implementing the new code set. Groups opposing ICD-10 have said that the implementation, with its large increase in codes and need to adapt healthcare systems, causes an unnecessary burden on providers.

“The transition to ICD-10 is time sensitive because of the urgent need to keep up with tracking, identifying and analyzing new clinical services and treatments available to patients. Continued reliance on ICD-9 is not a viable option when considering the risk to public health and the danger of relying on outdated and imprecise data,” AHIMA officials said in a statement.

“The healthcare industry has had an abundance of time to prepare for the transition to ICD-10. Many hospitals, healthcare systems, third-party payers and physicians’ offices have prepared in good faith and made enormous investments to be ready for the Oct. 1, 2014, deadline and the transition to ICD-10, an essential and robust coding system that will lead to improved patient care, reduced costs and maximize the investments in electronic health records (EHRs) and health data exchange,” the statement reads.

In addition to impacting the delivery of care, a delay in ICD-10 impacts more than 25,000 students in health information management (HIM) associate and baccalaureate educational programs, many of whom have learned to code exclusively in ICD-10, according to AHIMA.

“These students will not have the ability to code in ICD-9, which will make it difficult for them to find employment, pay back student loans, and become certified,” the statement said. “In the bigger picture, it is a further blow to a healthcare system already struggling to fill positions with qualified personnel as the demand for quality healthcare data increases.”

AHIMA Calls on Members to Request Removal of Delay Provision

AHIMA has put out a call to members and other stakeholders to contact their senators and ask them to pass a clean bill to fix SGR and not delay ICD-10.

When contacting congressional members, AHIMA has instructed callers to state that their senators should:

• Oppose the specific ICD-10 related language in the SGR patch legislation
• Reach out to Senate Majority Leader Harry Reid and Senate Chairman Ron Wyden to vote against H.R. 4302 and remove the ICD-10 language from any future bill

The Centers for Medicare and Medicaid Services estimates that a one-year delay could cost between $1 billion to $6.6 billion, according a statement from AHIMA officials. “This is approximately 10-30 percent of what has already been invested by providers, payers, vendors and academic programs in your district,” AHIMA wrote in a statement, which it encouraged its members to use when contacting Congressional representatives. “Without ICD-10, the return on investment in EHRs and health data exchange will be greatly diminished…  Let Senate Majority Leader Reid and Chairman [Ron] Wyden know that a delay in ICD-10 will substantially increase total implementation costs in your district.”

In addition to asking ICD-10 proponents to take to social media and contact senators, AHIMA will also be conducting a Twitter Chat on the potential ICD-10 delay at 10 a.m. CT, Monday, March 31, before the Senate votes. The hashtag #NoDelay will be used in the chat, and discussion will center on individuals’ opinion on an ICD-10 delay, discuss the amount of resources organizations have already invested in ICD-10, and discuss what individuals’ biggest concerns are regarding a potential delay.

Contacting Your Congressional Representatives

For more information on contacting your senators in Congress, visit AHIMA’s Advocacy and Public Policy senator look-up site at http://capwiz.com/ahima/dbq/officials/. Comments on this article are not forwarded to government officials.

For more information on AHIMA ICD-10 advocacy, visit http://www.ahima.org/about/advocacy.

Las recetas médicas ilegibles y las largas horas de espera que pasan los consumidores en las farmacias pudieran ser cosa del pasado a partir del próximo año.

Esto porque el día primero de abril de 2009 comenzará a funcionar en los Estados Unidos y en Puerto Rico la prescripción médica (“e-prescribing”).

El “e-prescribing” no es otra cosa que la receta escrita por el médico en un programa computarizado, en vez de escribirla a mano en un papel, como el galeno hace en la actualidad. La receta la escribirá en el consultorio, al instante, una vez examine al paciente y determine el medicamento que le prescribirá.

Para fomentar el uso de esta tecnología, a partir de abril, Medicare otorgará incentivos a los médicos que adopten el sistema de prescripción electrónica, dijo Delia Lasanta, directora del Centro de Servicios de Medicare y Medicaid (CMS por sus siglas en inglés) para Puerto Rico y las Islas Vírgenes.

Estos incentivos se extenderán por cuatro años, hasta el 2012. A partir de esa fecha, se penalizará a los médicos que no hayan implantado con éxito el programa electrónico de prescripción, a menos que demuestren la dificultad que han experimentado en el cumplimiento.

Tanto en Estados Unidos como en Puerto Rico, existen todavía muchas interrogantes sobre cómo será la interacción del programa con los distintos componentes del sistema de salud. Pese a las dudas, se asegura que el “e-prescribing” reducirá en gran medida la probabilidad de que el médico cometa errores al hacer las recetas.

Menos errores y más ahorros

Los estimados apuntan a que Medicare podría ahorrarse más de $150 millones en cuatro años, al reducirse los errores en las prescripciones.

Una vez el médico escriba la receta en la computadora, la transmitirá vía electrónica a la farmacia que el paciente le indique. “En e-prescribing” tiene que existir la libre selección del paciente a la hora de escoger la farmacia”, dijo Rosa Hernández, presidenta de MC-21, empresa administradora del beneficio de farmacia bajo la Reforma de Salud.

“Hay mucha confusión y se requiere todavía mucha educación. Esto no es una solución tecnológica, sino una iniciativa clínica”, señaló la presidenta de MC-21, quien también es farmacéutica.

Hernández explicó que el médico podrá ver en la pantalla de su computadora el historial del paciente como, por ejemplo, qué otros medicamentos toma, a qué médicos visita, y prescribir así una receta “limpia”, libre de errores o complicaciones.

La empresa Med Health -especializada en manejar sistemas electrónicos relacionados con la industria de la salud- comenzó recientemente a implantar un programa piloto de “e-prescribing” en Puerto Rico.

La prescripción electrónica es la primera fase de un proyecto más abarcador, que incluirá, entre otras, el “e-lab” para las pruebas de laboratorio y el “e-imaging”, hasta culminar con el récord médico completo del paciente en formato electrónico.

Betsy Barbosa, directora ejecutiva de la Asociación de Compañías de Seguros (Acodese), dijo que las aseguradoras están preparándose para moverse hacia la receta electrónica, aunque reconoció que aún hay varios obstáculos que salvar en Puerto Rico.

Recetas más rápidas

Opinó Barbosa que el “e-prescribing” será beneficioso, en particular para la gente que trabaja pues, desde la oficina del médico, éste enviará la receta a la farmacia, iniciando así el proceso de aprobación de la misma por parte del plan. De esa forma, el paciente economizará tiempo al no tener que hacer fila para entregar la receta en la farmacia, ni tampoco tendrá que esperar largas horas en lo que el farmacéutico obtiene la aprobación del plan.

La clase médica también le da la bienvenida al método de receta electrónica, aseveró Eduardo Ibarra, presidente del Colegio de Médicos Cirujanos de Puerto Rico. Esto porque reducirá costos a lo largo de toda la cadena, incluyendo el médico, el paciente y las aseguradoras.

Ibarra destacó que el sistema electrónico advertirá al médico, entre otras cosas, las dosis adecuadas de medicamento para cada paciente, así como las reacciones que puede generar un fármaco al interaccionar con otros que tome el paciente.

Pese a todos esos beneficios, la nueva Ley de Farmacias de Puerto Rico exige que el paciente entregue la receta en original a la farmacia para poder procesarla y despacharla. Esto significa que aquí habrá que enmendar dicho estatuto para atemperarlo a la ley federal, advirtió María Isabel Vicente, directora ejecutiva de la Asociación de Farmacias de Comunidad (AFC).

Vicente indicó que todos los sectores de salud en la Isla están a favor del “e-prescribing”, aunque reconoció que Puerto Rico está algo atrasado en la orientación sobre cómo va a funcionar el sistema. La AFC está convocando a todos los proveedores de salud -médicos, laboratorios, aseguradoras, farmacias de cadena e independientes y otros- a una reunión para discutir las enmiendas que se le harán a la Ley 247 (Ley de Farmacias de Puerto Rico). La reunión será el próximo miércoles 27, en el Colegio de Farmacéuticos, a la 1:00 p.m.