SOURCE: PracticeSuite, Inc.

PracticeSuite, Inc.

June 29, 2015 12:38 ET

Petition Calls on President Obama to Protect Physicians From Impending ICD-10 Financial Crisis

SANTA CLARA, CA--(Marketwired - June 29, 2015) - Greatly concerned about the potential for a devastating financial crisis due to the changeover to ICD-10, Silicon Valley, Ca-based PracticeSuite has written a petition asking President Obama to issue a series of three executive orders designed to mitigate the impact on small physician practices. The software maker has posted the petition on its website and is asking small healthcare organizations around the country to sign it.

A handful of pundits believe that the impact from changing from ICD-9 diagnosis codes to the more-complicated ICD-10 set of codes will be negligible, and the Centers for Medicare and Medicaid (CMS) says it has contingency plans in place for struggling practices, although it refuses to say what that plan is.

However, there is mounting evidence that small practices, which employ 70% of private practice physicians, are finding the transition to ICD-10 a major challenge and will not be ready to successfully submit perfect claims using the new codes on October 1. Indeed, CMS itself predicts the move from 14,000 diagnosis codes to 141,000 will cause a 10% increase in claim errors, a 40% increase in A/R days, and a 200% rise in claim denials. In many cases, these events spell disaster for small practices.

Lawmakers are also concerned about the changeover. Republican Ted Poe of Texas has proposed the Cutting Costly Codes Act of 2015 (H.R. 2126), which would prohibit the federal government from requiring the medical community to comply with ICD-10. A bill by Republican Diane Black of Tennessee, Increasing Clarity for Doctors by Transitioning Effectively Now Act (H.R. 2247), would require HHS to first provide transparent testing to assess whether the Medicare fee-for-service claims processing system based on ICD-10 is fully functioning.

PracticeSuite, recognizing that diagnosis codes are not the basis of payer reimbursements (Current Procedural Terminology codes are), is suggesting a different approach, one that would reduce or eliminate the predicted short-term risks from the changeover while allowing the transition to take place as scheduled.

PracticeSuite executives, including CEO Vinod Nair, are asking the President to issue the following executive directives:

  1. For 12 months following 10/1/15, payers cannot deny claims based solely on minor ICD-10 diagnosis coding errors.
  2. During those 12 months, payers cannot delay ICD-10 claims payments. Errors will be reported to providers with a request for corrected information.
  3. During those 12 months, payers cannot enforce the additional clinical documentations requirements associated with ICD-10.

"We believe that only an executive order can provide a true safeguard to our already fragile health system during the ICD-10 transition," said Nair. "Rather than trying to cancel the changeover, delay it, or create a grace period that extends to CMS but not other payers, we understand that the best way to resolve the situation is to have the President step in and separate the new diagnosis coding system from the ability of physicians to get paid for their work seeing patients."

Other healthcare organizations agree. Petition signatory Dr. Judy Vanmalderen of Ohio calls the ICD-10 transition "a terrible financial burden for doctors who are trying to maintain a solo practice." Another signatory says her office is "still recovering from having to implement EHR."

Dr. Susan Dugoni of California says, "The vendors that supply our vaccines, office supplies, etc. and our staff will still need to be paid even if we are not being paid by the insurance companies because of coding issues. Those of us in... small, independent practices will be in major financial trouble if we cannot pay our bills while the kinks are being worked out."

Please read and sign the petition.

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Contact Information

  • For more information, contact:

    Michael Sculley
    VP Marketing
    Msculley {at}