AMA keeps up its vigorous opposition to ICD-10 implementation


Last month while we were checking our lists twice, the American Medical Association (AMA) sent a letter to Santa Claus.

Actually they sent it to Marilyn Tavenner, acting administrator of the Centers for Medicare & Medicaid Services (CMS). And the AMA got scores of medical associations to co-sign it.

What they asked for was to halt ICD-10 implementation because ICD-10 implementation will be a costly burden that does nothing to improve patient care and there are other federally mandated initiatives that compete for physician resources.

The first point about cost and the number of ICD-10 codes never gets old. But it's that second point about other federally mandated initiatives that really captures my attention. According to the logic of the letter, physicians who are distracted by the ICD-10 transition run the risk of not complying with " e-prescribing, EHR meaningful use, and the Physician Quality Reporting System (PQRS) and value-based modifier programs." Then that will mean penalties for non-compliance.

Also, physicians won't be able to participate in new business models that healthcare reform will create.

Hopefully those initiatives and business models won't require granular data. Oh wait.

There's hope for physicians. The letter does complain that the sustainable growth rate mandated a cut in Medicare physician fees on Jan. 1. The fiscal cliff deal fixed that and a 2 percent sequester. So Santa did come through.

What Santa and his elves will do about the ICD-10 deadline is anyone's guess. I think that he's going to want more granular data to see which healthcare organizations are naughty or nice.

And I have a hard time believing if CMS does scrap ICD-10 implementation for a code set to be named later, that physicians will be happy when it's time for that implementation. Systems and training still will be needed. And that's going to cost money.

I think this is more about the various noncompliance penalties for federally mandated healthcare reform and a lack of incentives for ICD-10 implementation. This opposition would probably become less vigorous if some money became available.

In the past I've doubted that Congress would be willing to spend more money. But who knows. Maybe if you package it as some sort of healthcare stimulus package that will enable the industry to detect waste and fraud better. Especially if they believe it's going to family doctors -- the kind you see in Norman Rockwell paintings. Who knows.