Executive Officer James Madara, MD, said the ICD-10 mandate “will create significant burdens on the practice of medicine with no direct benefit to in- dividual patient care, and will compete with other costly transitions associated with the quality and health IT [infor- mation technology] reporting program.” (See “ICD-10 Will Change Your Practice, Expert Warns,” page 9-11.)
He added that the timing of the tran- sition “could not be worse as many phy- sicians are currently spending significant time and resources implementing elec- tronic health records in their practices.” The Texas Medical Association con- vinced AMA to oppose the switch to ICD- 10. The AMA House of Delegates adopt- ed an anti-ICD-10 resolution introduced by the Texas delegation and others at its meeting in November. The TMA resolution asked AMA to “immediately petition the Centers for Medicare & Medicaid Services to stop
implementation and development of all new coding and billing standards includ- ing ICD-10.” AMA delegates voted to direct AMA
to “vigorously work to stop the imple- mentation of ICD-10 and to reduce its unnecessary and significant burdens on the practice of medicine,” and to “work with other national and state medical and informatics associations to assess an appropriate replacement for ICD-9.” “ICD-10 is going to be an absolute di- saster in implementation for the physi- cians of this country,” TMA Trustee Da- vid Teuscher, MD, of Beaumont, told the AMA Reference Committee on Legisla- tion in urging the committee to support the resolution. “It will be disastrous for those who are our members, and they will ask, ‘Why didn’t the AMA do some- thing?’ Those who are not our members will say, ‘See, the AMA didn’t do some- thing.’ It is time for the AMA to stand up and say ‘no’ to the implementation of ICD-10.”
He said estimated ICD-10 implemen- tation costs for a three-physician practice are $83,000 per doctor and $28,500 per physician for a 10-doctor practice. In his letter to Speaker Boehner, Dr. Madara said implementation of ICD-10 would be costly for physicians. “Depend- ing on the size of the medical practice, the total cost of implementing ICD-10 ranges from $83,290 to more than $2.7 million,” he wrote. Dr. Madara also urged the speaker
to reevaluate timelines for penalties for physicians who fail to adopt eprescrib- ing, achieve meaningful use of electronic health records, or participate in the Phy- sician Quality Reporting System. “Physicians are being required to meet separate, distinct requirements under these three overlapping programs and have been and will be unfairly penal- ized if they decide to participate in one program over the other,” he said. He concluded, “Stopping the imple- mentation of ICD-10 and calling on appropriate stakeholders, including physicians, hospitals, payers, national and state medical and informatics asso- ciations, to asses an appropriate replace- ment for ICD-9 will help keep adoption of EHRs and physician participation in
48 TEXAS MEDICINE March 2012
quality and health IT programs on track and reduce costly burdens on physician practices.”
HHSC picks physicians for Medicaid advice
The Texas Health and Human Services Commission (HHSC) appointed three new committees to advise it on Medic- aid and Children’s Health Insurance Pro- gram (CHIP) payment issues. The legislature created the commit- tees in 2011.
The Quality-Based Payment Advisory Committee will advise HHSC on per- formance and standards and outcomes measures for Medicaid and CHIP. It was created under Senate Bill 7 by Sen. Jane Nelson (R-Flower Mound), which sought to refocus payment of health care servic- es from fee for service to quality-based payments.
The Physician Payment Quality Com- mittee will use national guidelines to help determine the 10 most overused or unnecessary services in the Texas Medic- aid program. State law directs HHSC to decrease Medicaid payments for services that should not be provided. House Bill 1, the two-year budget bill, established the committee. Finally, the Neonatal Intensive Care Unit Council will advise HHSC on stan- dards for neonatal intensive care units and on the development of an accredi- tation process for a neonatal intensive care unit to receive Medicaid payments. House Bill 2636 by Rep. Lois Kolkorst (R- Brenham), who chairs the House Public Health Committee, created the council. Nearly three dozen Texas physicians
were appointed to serve on these pan- els, including TMA President-Elect Mi- chael Speer, MD, of Houston, who was named to the Neonatal Intensive Care Unit Council. n
Ken Ortolon is senior editor of Texas Medicine. You can reach him by telephone at (800) 880-1300, ext. 1392, or (512) 370-1392; by fax at (512) 370-1629; or by email at
ken.ortolon@texmed.org.
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