Breaking News – ICD-10 Ruling

Healthcare Business News

BREAKING: One-year delay on ICD-10 to October 2014 finalized

By Maureen McKinney

Posted: August 24, 2012 – 12:45 pm ET


The federal government has finalized a one-year delay in the compliance deadline for the nationwide conversion to ICD-10 code sets. The delay, first proposed in April, will move the compliance deadline to Oct. 1, 2014.

HHS said the extra time would allow healthcare organizations—small organizations in particular—adequate time to get ready for the changeover.

“By delaying the compliance date of ICD-10 from October 1, 2013 to October 1, 2014, we are allowing more time for covered entities to prepare for the transition to ICD-10 and to conduct thorough testing,” HHS said in the rule. “By allowing more time to prepare, covered entities may be able to avoid costly obstacles that would otherwise emerge while in production.”

HHS included the change in a 208-page final rule (PDF) establishing a unique health plan identifier for all insurers. In a news release on the CMS’ websiteannouncing the rule, HHS said the identifier—along with other administrative simplification regulations included in the healthcare reform law—will save the healthcare system an estimated $6 billion over the next decade.


“These new standards are a part of our efforts to help providers and health plans spend less time filling out paperwork and more time seeing their patients,” HHS Secretary Kathleen Sebelius said in the release.

Read more: BREAKING: One-year delay on ICD-10 to October 2014 finalized | Healthcare business news and research | Modern Healthcare

Aetna To Purchase Coventry

Aetna to acquire Coventry in $5.7 billion deal

By Gregg Blesch

Posted: August 20, 2012 – 8:15 am ET


Aetna plans to buy Coventry Health Care for $5.7 billion in a cash and stock deal that will expand the company’s reach in Medicaid and Medicare.

The deal is the latest big play by a national insurer to get a bigger footprint in Medicaid as the programs are poised to grow dramatically under the Patient Protection and Affordable Care Act.

The transaction is valued at $7.3 billion including assumption of Coventry’s debt, Aetna said in a news release.

Coventry covers about 4 million members in medical plans and 1.5 million in Medicare Part D prescription drug plans, according to the release.

Supreme Ct. Denies CA Medicaid case

Article published February 22, 2012
Calif. Medicaid case heads back to lower court
By Gregg Blesch Posted: February 22, 2012 – 12:45 pm ET
The U.S. Supreme Court sent a widely watched California Medicaid case back to a lower court, declining to rule whether providers can sue states to enforce the federal statute.
California hospitals and other providers argued in five lawsuits that state amendments to the Medicaid program, including a 10% reimbursement cut, violated language in the federal law that payments are sufficient to sustain quality and access for beneficiaries. The 9th U.S. Court of Appeals agreed and issued injunctions
blocking the state from making the changes.
In the meantime, however, the CMS approved some of the plan amendments and the state withdrew most of the others.
“While the cases are not moot, they are now in a different posture,” Justice Stephen Breyer wrote in an opinion for a 5-4 majority. “The providers and beneficiaries continue to believe that the reductions violate the federal provision the agency’s view to the contrary notwithstanding.” The 9th Circuit’s injunctions remain in place.
Breyer noted, however, that the providers may now more appropriately seek review of the CMS’ decisions rather than basing their challenge on the supremacy of federal law over the state actions. Breyer noted that the administrative review requires deference to the agency’s decisions and “to permit a difference in result here would subject the states to conflicting interpretations of federal law by several different courts (and the agency), thereby threatening to defeat the uniformity that Congress intended.”
The Supreme Court remanded the case to the 9th Circuit.