On April 1, 2014, President Obama signed into law H.R. 4302, Protecting Access to Medicare Act of 2014. This bill provides a temporary fix to the Medicare sustainable growth rate (SGR) which has repealed the 24% reduction in reimbursements which was due to go into effect that same day. Industry stakeholders would prefer a permanent fix but most are in favor of stopping the disastrous drop in Medicare reimbursement rates.
One of the provisions of this bill is that it mandates ordering physicians to use clinical decision support tools to justify the prescription of advanced imaging procedures. Another provision forces the Centers for Medicare and Medicaid Services (CMS) to produce data to justify a 25% multiple procedure payment reduction on certain imaging procedures provided to the same patient, on the same day, in the same session. Another provision puts a ceiling on the reduction of certain codes.
Earmarked on this bill was the delay of ICD-10 until at least Oct 1, 2014. While the delay will cost billions of dollars industry-wide, it will give those who are not prepared for ICD-10 time to catch up and be ready when the time comes for us to implement the guidelines and practices that will be required of us.
It is recommended that you do not stop in your efforts to prepare for the change that was scheduled to take effect Oct 1, 2014. If the preparations grind to a halt now, where will we get the motivation to ramp our efforts back up in another year? If we continue to put our efforts into moving forward, the change to ICD-10 should not be so extreme as we will have had more time to prepare.