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The RAConteurDue to the upcoming Thanksgiving holiday, my usual Friday post on pertinent health care issues appears today.
Last night, in my nightly bout with insomnia, and under orders from my wife to clear our DVR, I watched an under-appreciated gangster movie from 1980 called “The Long Good Friday”, starring Bob Hoskins and Helen Mirren. The movie revolves around a British mobster who, on the brink of an important partnership with the American Mafia, suddenly finds himself under attack from someone he can’t identify. Bluntly, the only reason it was on my DVR at all is that it was produced by Hand-Made Films, which was the production company of an old musician named George Harrison. I’m told that he was in a rather groundbreaking band at one time.
It is indeed a horrible feeling to have a tormentor whose name and motivations you cannot see. On the other side of the coin is to know long in advance what your biggest challenges are and to ignore them in the hopes that they go away. We had a blunt example of this in the last week from a new policy release emanating from the Semi-Annual Meeting of the AMA in New Orleans. While three of the new policies made sense, based on the setting of the meeting, I’m basing the adoption of the following fourth policy on too many hurricane drinks and an overdose of zydeco music.
The AMA has decided that they will “work vigorously to stop” implementation of ICD-10 on October 1, 2013. The argument the AMA makes is that ICD-10 has no benefit to direct patient care and needlessly inflates administrative cost and disrupts work flow.
I get asked a question on ICD-10 often from physicians in the field. It goes something like this:
“Are they REALLY going to go through with this ICD-10 thing?”
I am going to say this one more time, to a mass audience, which can feel free to continue to spread it far and wide to all of their acquaintances in the industry. There will be no delays of the implementation date, there will be no sudden cancellations, and this is not a test, drill, rehearsal, exercise or interpretive dance presentation by Cirque du Soleil called “Illusion”. The FINAL (“FINAL” meaning the last and not the penultimate) implementation date is October 1, 2013. If you use an ICD-9 code on an insurance claim after that date, you will NOT (“NOT” meaning none, nada, zip, zero or the null set) receive an insurance payment. There is no punch line and no one is going to shout “APRIL FOOL”. It’s happening in 679 days, without fail.
Let’s review recent history. CMS’ ICD-10 proposed rule stated an implementation date of October 1, 2012. Mercifully, the final rule bumped it back one year to 2013. The final date represents the end of movement of the date. CMS has no inclination to change it again, and says so every time they provide education on the topic, usually within the first 5 minutes of the presentation.
I would imagine that by saying the phrase ”work vigorously to stop” implementation, the AMA is talking about throwing a bomb in the form of lobbying money towards the nearest corrupt politician (unfortunately, no shortage of targets) in order to introduce legislation to extend the deadline. I bet they figure that if they pinpoint their strike, perhaps they can get a pay fix for 2012 at the same time. If this is the calculus, may I be the first to provide each member of the AMA with advanced booking for a suite at the Fat Chance Hilton?
Might I suggest a more noble use for that money, such as setting up a fund to assist small-group physicians with implementation, or providing regional education opportunities on the substantial impact ICD-10 will have on physician documentation? Since the AMA was more than happy to state in the new policy that small practices would have to spend over $83,000 to fully implement ICD-10, wouldn’t it be more useful to build some much-needed goodwill in the provider community by offering such assistance, rather than yelling at clouds as their membership continues to plummet due to lack of a relevant or coherent argument in the modern medical delivery landscape?
When I first became a certified coder in 1998, I was told that ICD-10 was on the horizon. The original go-live date I heard at that time was October 1, 2000. When final implementation hits, 15+ years of speculation ends. Anyone without their head in the sand knew this was coming eventually. This isn’t some sudden bomb deviously planted in your decanter of tongue depressors by an anonymous assassin. The time to build a flood wall is before the 100-year rains, not after. My advice on ICD-10, to the AMA and anyone else listening, is to hit the ground running, rather than jumping a shark on water skis in the form of issuing a foot-stomping policy of denial.
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INCREDIBLE!!! Who died and made them CMS?
This is a big temper tantrum by the AMA.
It may be the beginning of the end of the AMA’s lobbying power – there are many groups, each for its own specialty, and this type of fight may “divide and conquor” the AMA.
[...] which covered basically the same territory as the Boehner letter. I covered this topic in a post at the time, and what I said then still holds true. Rather than spitting into a headwind in a [...]
[...] which covered basically the same territory as the Boehner letter. I covered this topic in a post at the time, and what I said then still holds true. Rather than spitting into a headwind in a [...]