NCPA - National Center for Policy Analysis

Another Unfunded Mandate That Could Set Back Health Care

February 24, 2015

The American medical community will have a new burden, come October 2015. Doctors have billed their patients using ICD-9 codes since the 1980s but if Congress fails to act, a new and vastly more complicated system will replace the ICD-9. NCPA senior fellow John R. Graham describes the new ICD-10 as easily ridiculed

The change will be a boon for healthcare IT companies that stand to profit from the new system.  However, the shift will place a heavier burden on solo practitioners and other small, local health providers. While a Government Accountability Office (GAO) report recommends moving forward with the transition, there are dissenting opinions.

  • Nearly three-quarters of the Centers for Medicare and Medicaid Services' stakeholders contacted by GAO expressed serious concerns about the lack of adequate training and testing.
  • One-fourth of physician practices indicate they are not prepared for the transition.

The impact of such a transition is likely to fall disproportionately on rural and elderly populations. Doctors will spend more time on coding and less time practicing medicine. Doctors treating Medicaid patients may also lose reimbursements until their state governments can adjust to the ICD-10 system.

Congress could avoid the financial losses that will follow from the required investment in new software programs. Additionally, imposing yet another unfunded mandate on the medical community will result in prolonged confusion as state governments and physician practices divide their time between catching up to a more complex coding system and treating patients.

Source: John Grimsley, "Congress Is About to Impose Another Unfunded Mandate on Doctors," Daily Signal, February 19, 2015.


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