Ways & Means Committee calls for ICD-10 contingency plan
Ways & Means Committee members call upon CMS to have plans in place to avoid disruption of payment to providers.
The Ways & Means Health Subcommittee Chairman and 12 other Congressman are calling upon the Centers for Medicare and Medicaid Services to have a contingency plan in place for processing claims under ICD-10.
In the June 1 letter to CMS's acting administrator, Subcommittee Chairman Kevin Brady, R-Texas and 12 members of the House Ways and Means Committee recommend CMS make public a contingency plan for how Medicare will process claims in the event it is unable to do so under ICD-10 diagnostic codes that go into effect Oct. 1.
They call for a period of time under which less specific codes are accepted.
[Also: ICD-10 bill surfaces, calls for delay]
"Providers need to know that they will receive timely payment for the services they furnish to seniors in the event that CMS systems fail to work as intended," they wrote.
The Administration needs to take steps to instill confidence for a smooth transition, to avoid cash flow problems among providers and physicians that could lead to patient disruptions, the letter states.
CMS should also indicate whether it would accept claims submitted under codes other than ICD-10 that are clinically accurate, they said.
End-to-end testing of the system should be expanded beyond the current 2,500 providers, they said, with emphasis placed on the smaller providers.
[Also: AMA chief says US should wait for ICD-11]
Providers should be educated on the resources available to avoid claims processing disruption, they said.
"Providers need to be aware that fallback options are available if they experience problems with their billing systems," the letter states.
CMS should also coordinate with non-Medicare payers as feasible.
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The letter also calls upon CMS to make public a description of how ICD-10 codes would be applied to incentive payment programs for reporting quality of care and other metrics, including how any anticipated increase in provider requests for incentive program re-determination would be handled. Also, they ask how ICD-10 codes would be incorporated into anti-fraud, waste and abuse efforts so as not to increase vulnerabilities.
The letter was sent to Andy Slavitt, acting administrator for CMS.
Brady said in a release, "Unlike the disastrous ACA rollout, the Administration owes it to our doctors to ensure a smooth transition to ICD-10."
Twitter: @SusanMorseHFN
