Health IT Bill Moving Through Congress ICD 10 Standards Included

Health IT Bill moving through Congress – ICD 10 Standards included

Congress continues to push ahead with legislation to encourage great utilization of Health Information Technology. On July 27, 2007, by a vote of 270 to148, the House of Representatives passed H.R.4157, the Health Information Technology Promotion Act of 2005. This follows similar legislation passed earlier this year by the Senate (S. 1481, passed on November 18, /2005). When the Congress returns in September, the House and Senate will convene a Conference Committee to attempt to iron out the differences in the two bills.

H.R. 4157 would formally establish the office of the National Coordinator for Health Information Technology. Currently this office exists under a Presidential Executive Order (EO). By formally creating the office, Congress can appropriate money for this office and the staff that run the office. Because of the present EO arrangement, staff are “assigned” from other agencies and money to run the office comes from money appropriated to other agencies.

The bill would direct the National Coordinator to: (1) maintain, direct, and oversee the continuous improvement of a strategic plan to guide the nationwide implementation of interoperable health information in both the public and private health care sectors; and (2) serve as the coordinator of federal government activities relating to health information technology.

The legislation also outlines the conditions under which non-monetary compensation/inducements can be made by a hospital to a physician without the compensation or gift being considered a prohibited payment (subject to civil and criminal penalties) made as an inducement to reduce or limit services to certain individuals.

A little noticed but highly controversial provision regarding adoption of the ICD-10 standards was also included in the bill. The legislation directs the Secretary of Health and Human Services to promulgate a final rule for upgrading the International Statistical Classification of Diseases and Related Health Problems, 9th revision, Clinical Modification (ICD-9-CM) codes. Although this is something that has been in the works for a number of years, the legislation would mandate implementation of the ICD-10 standards by October 1, 2010. CMS officials have stated that the agency could implement ICD-10 by the October 1, 2010 deadline.

The ICD-10 language is NOT included in the Senate passed version of the Health IT bill.

Also, the bill directs that no later than 180 days after the date of the enactment of this Act, the Department, in consultation with relevant public and private entities, shall develop a strategic plan with respect to the need for coordination in the implementation of—

(1) transaction standards under section 1173(a) of the Social Security Act, including modifications to such standards; and,

(2) any updated versions of the International Classification of Diseases (ICD), including the replacement of ICD-9.

News reports published at the time of House passage of H.R. 4157 indicate that while the ICD-10 implementation deadline was supported by the Associations representing hospital and device manufacturers, the legislative language was vigorously opposed by the Blue Cross/Blue Shield Associations as well as the Medical Group Management Association.