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Apr 01 2014

Update: Congress Approves Doc Fix Patch & ICD-10 and Two-Midnight Rule Delays

Late last week, House Speaker John Boehner indicated that a deal had been reached between Speaker Boehner and Senate Majority Leader Harry Reid to provide another temporary “doc fix” and delay ICD-10 implementation and two-midnight rule compliance. The bill was passed by the House on March 27 and approved by the Senate on March 31.

The legislation provides a 12-month temporary doc fix to avoid and delay cuts in physician payments imposed by Medicare’s sustainable growth rate (SGR) formula. Efforts had been underway to repeal and replace the SGR with a permanent doc fix. For more information on these efforts and the SGR in general, see the von Briesen blog here.

The legislation also delays the compliance date for conversion to ICD-10 diagnostic and procedural codes by at least an additional year. After a series of delays, ICD-10 implementation was set for a go live date of October 1, 2014. However, the legislation delays ICD-10 implementation until at least October 1, 2015.

In addition, the legislation provides a six month extension – through March 31, 2015 – to comply with the two-midnight rule, which limits hospital Medicare reimbursement for short in-patient stays. For more on the two-midnight rule, see the von Briesen blog here.

The current doc fix patch expired March 31; if signed by the President, the legislation will avoid the approximately 24% cut in physician reimbursement,