Delayed deadlines for Meaningful Use and ICD-10 reflect overburdened healthcare providers.

by Sarah Cronan Spurlock

Amidst an ongoing national debate on healthcare reform, and with threats of shrinking reimbursement and rising healthcare costs looming large, healthcare providers continue to face many challenges that can have a significant impact on their bottom lines. The administrative burden and expense of keeping up with increasing demands for healthcare technology is one of these challenges. In the past few months, however, there has been an apparent recognition by government agencies that some of these technology demands–at least as initially conceived–have proven to be overly ambitious.

Included in the technology initiatives requiring significant attention from hospitals, physicians and other healthcare providers are efforts to achieve a “meaningful use” of certified electronic health records (EHR) and preparation for the switch to diagnosis and procedure codes under the International Classification of Diseases, 10th Edition, commonly known as ICD-10. But, the demands don’t stop there. Healthcare providers have been grappling with upgrading systems to accommodate HIPAA 5010 transaction standards as well, a move which is necessitated by the upcoming transition to ICD-10 codes. Implementing EHRs and preparing for changes in billing and coding are costly and time-consuming endeavors. Even for those who have prioritized their technology efforts, many have found that the time and expense is too great to accomplish the objectives within the previously required timeframes. For those providers, recent announcements from the U.S. Department of Health and Human Services (HHS) may provide some welcome relief.

Three Stages of Meaningful Use
“Meaningful Use” refers to healthcare providers’ ability to demonstrate use of a certified EHR for certain functions aimed at improving patient care while reducing medical errors and costs. Achieving compliance with Meaningful Use requirements makes qualifying professionals and hospitals eligible for financial incentive payments in connection with government EHR incentive programs. Medicare uses a carrot and stick approach. It offers incentive payments for demonstrating Meaningful Use of a certified EHR within a specified timeframe, while those providers who fail to achieve Meaningful Use by 2015 risk cuts to Medicare reimbursement.

Medicare’s Meaningful Use requirements are being implemented in three stages, with incentive payments possible for up to four or five years, depending on the type of provider and the year in which the provider first demonstrates Meaningful Use. Under the initial timeline, providers who attested to Stage 1 Meaningful Use in 2011 would be required to attest to Stage 2 standards by 2013, while those who attested to Stage 1 Meaningful Use in 2012 had until 2014 to attest to Stage 2. On March 7, 2012, the Centers for Medicare & Medicaid Services published its proposed rule on Stage 2 Meaningful Use in the Federal Register. In addition to setting measures for Stage 2, the proposed rule revises Stage 1 objectives and gives providers who attested to Stage 1 Meaningful Use in 2011 additional time, until 2014, to reach Stage 2.

Welcomed Relief
The delayed implementation date for Stage 2 Meaningful Use is not the only delay we have seen in recent months. On February 16, 2012, HHS announced that it will be delaying the date for compliance with ICD-10 codes. That announcement came on the heels of the January 1, 2012 compliance deadline for implementing HIPAA 5010, which impacts the exchange of electronic information between healthcare providers and health plans for electronic transactions such as claims payment, claims status inquiries, and treatment authorizations, and is a prerequisite for the transition to ICD-10. According to the press release announcing the delayed compliance date, originally set for October 1, 2013, the decision appears to have been prompted by concerns about administrative burdens providers will face in the coming years.

HHS Secretary Kathleen Sebelius is quoted as saying that HHS will “work with the provider community to reexamine the pace at which HHS and the nation implement these important improvements to our healthcare system.” The press release does not specify a new ICD-10 compliance date, but simply states that HHS will “announce a new compliance date moving forward.”

In the wake of these announcements, providers who have not yet started preparation for these changes would be wise to learn from the experiences of those who have. Eventually the compliance dates will arrive and it is clear that providers need to act now to allow sufficient time to meet these significant technology demands and avoid the risk of Medicare reimbursement cuts and costly payment disruptions.

Sarah Cronan Spurlock is an associate with Stites & Harbison, PLLC, in Louisville, Ky.