[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2247 Introduced in House (IH)]

114th CONGRESS
  1st Session
                                H. R. 2247

 To require the Secretary of Health and Human Services to provide for 
  transparent testing to assess the transition under the Medicare fee-
   for-service claims processing system from the ICD-9 to the ICD-10 
                   standard, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 12, 2015

Mrs. Black (for herself and Mr. Harris) introduced the following bill; 
  which was referred to the Committee on Energy and Commerce, and in 
    addition to the Committee on Ways and Means, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
 To require the Secretary of Health and Human Services to provide for 
  transparent testing to assess the transition under the Medicare fee-
   for-service claims processing system from the ICD-9 to the ICD-10 
                   standard, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Increasing Clarity for Doctors by 
Transitioning Effectively Now Act'' or the ``ICD-TEN Act''.

SEC. 2. IMPLEMENTATION OF HIPAA CODE SET STANDARDS.

    The Secretary of Health and Human Services shall implement, 
administer, and enforce, in accordance with this Act and consistent 
with section 212 of the Protecting Access to Medicare Act of 2014, the 
regulations issued on January 16, 2009 (74 Fed. Reg. 3328) and on 
September 5, 2012 (77 Fed. Reg. 54664) that provide for the replacement 
of ICD-9 with ICD-10 as a standard for code sets under section 1173(c) 
of the Social Security Act (42 U.S.C. 1320d-2(c)) and section 162.1002 
of title 45, Code of Federal Regulations.

SEC. 3. COMPREHENSIVE TESTING.

    (a) In General.--The Secretary of Health and Human Services shall 
conduct a comprehensive, end-to-end testing process to assess whether 
the Medicare fee-for-service claims processing system based on the ICD-
10 standard is fully functioning.
    (b) Availability.--The Secretary shall make the end-to-end testing 
process available to all providers of services and suppliers (as 
defined under subsections (u) and (d), respectively, of section 1861 of 
the Social Security Act (42 U.S.C. 1395x) participating in the Medicare 
fee-for-service program under parts A and B of title XVIII of such Act 
(42 U.S.C. 1395c et seq.).
    (c) Certification.--
            (1) In general.--Not later than 30 days after the date of 
        completion of the end-to-end testing process, the Secretary 
        shall submit to Congress a certification on whether or not the 
        Medicare fee-for-service claims processing system based on the 
        ICD-10 standard is fully functioning.
            (2) Additional steps in case standard is not fully 
        functioning.--In the case that the Secretary certifies under 
        paragraph (1) that such processing system based on the ICD-10 
        standard is not fully functioning, the Secretary shall include 
        in the submission to Congress under paragraph (1) additional 
        steps that will be taken to achieve a certification that such 
        processing system based on such standard is fully functioning 
        and the anticipated timeframe for achieving such certification.
    (d) Definitions.--In this Act:
            (1) End-to-end testing process.--The term ``end-to-end 
        testing process'' means an process designed to demonstrate 
        that--
                    (A) submission of claims to the Secretary with ICD-
                10 codes and the receipt of a remittance advice can be 
                accomplished on a routine basis at high volume levels;
                    (B) any software changes made to support the ICD-10 
                standard result in appropriately adjudicated claims;
                    (C) accurate remittance advices are produced; and
                    (D) all phases of the implementation of the ICD-10 
                transition are operable.
            (2) Fully functioning.--The term ``fully functioning'' 
        means, with respect to the period of the end-to-end testing 
        process of the Medicare fee-for-service claims processing 
        system based on the ICD-10 standard, that the percentage of 
        claims accepted under such system so based during such period 
        is equal to or greater than the percentage of claims accepted 
        during the calendar year previous to such period, based on the 
        ICD-9 standard.

SEC. 4. IMPLEMENTATION PERIOD.

    (a) In General.--The implementation period during which the 
transition to ICD-10 standards shall be made shall begin on October 1, 
2015, and end on the date that is 18 months after the date on which a 
certification is made under section 2(c) that the Medicare-fee-for 
service claims processing system based on the ICD-10 standard is fully 
functioning.
    (b) Safe Harbor.--During the implementation period described in 
subsection (a), no claim submitted for payment under title XVIII of the 
Social Security Act by a health care provider pursuant to the ICD-10 
standard medical data code sets shall be denied due solely to the use 
of an unspecified or inaccurate subcode.
    (c) Assistance.--During the implementation period described in 
subsection (a), the Secretary shall take affirmative steps to assist 
health care providers subject to section 1173(c) of the Social Security 
Act (42 U.S.C. 1320d-2(c)) and section 162.1002 of title 45, Code of 
Federal Regulations, in identifying appropriate ICD-10 subcodes.
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