Savickis clearly has both the institutional knowledge of how HHS works as well as the connections and expertise in the health IT departments to be the AMA’s strongest advocate. She is not AMA’s only connection to CMS and HHS, however, lobbyist Sylvia Trujillo recently served as a Litigation Attorney to CMS and an Assistant Regional Counsel to HHS.
A code set Civil War
AMA’s efforts were only one side of the debate. Across the battlefield, advocating in favor of ICD-10 implementation was a smaller association, the American Health Information Management Association (AHIMA). AHIMA, which represents health information professionals, came out publicly against AMA’s position.
AHIMA advocated for implementation arguing that ICD-10 is critical because it “is at the foundation of healthcare information changes underway in the United States,” stated Dan Rode, AHIMA’s vice president of advocacy.
[Related: The imminent industry association Civil War over ICD-10.]
In comparison to AMA, AHIMA’s lobbying operations were no match. AHIMA disclosed spending the minimum on lobbying, less than $5,000, and employed just two lobbyists.
During the debate AHIMA’s only lobbying efforts around ICD-10 were limited to issuing statements to the media against AMA’s actions. AHIMA has not disclosed any government lobbying on ICD-10 as its efforts have been primarily focused on the public relations front.
AMA and AHIMA are not the only organizations that have been involved in lobbying on ICD-10. In the last few years over 40 organizations have disclosed lobbying the government on ICD-10, including a mix of associations, health care providers, technology vendors, and other industry-related organizations.
In 2011, 12 organizations and eight Blue Cross Blue Shield affiliates disclosed lobbying related to ICD-10. This group includes notable associations such as:
- American College of Surgeons
- American Society of Anesthesiologists
- Joint Council of Allergy, Asthma And Immunology
- Healthcare Billing and Management Association (HBMA)
One of the groups listed is presumed to have a similar stance as AHIMA on ICD-10, HBMA, but chose not to be public in the media and other venues with their efforts.
The Medical Group Management Association shares the same concerns about the cost of ICD-10 as the AMA yet has refrained from joining the lobbying fight. In 2011 the organization doubled its lobbying expenditures going from $330,000 in 2012 to $670,000 in 2011. The group has given no indication they will unleash their lobbying resources on the ICD-10 issue but they are positioning themselves to be well-equipped should they decide to get involved.
Corporations have also disclosed lobbying on ICD-10, with two of the most notable being:
- 3M: Disclosed lobbying for “ICD-10 Adoption” and “ICD-10 Implementation” in 2011. 3M produces software to help with ICD-9 to ICD-10 conversion and has already spent $4.5 million on its lobbying activity in 2011, making it a powerful player in the lobbying industry and potentially an ally for supporters of ICD-10 implementation.
- MVP Health Care: Disclosed advocating concerns with negative consequences on costs associated with federally mandated ICD-10 program. The company has spent $160,000 on their lobbying activity in 2011 and is a potential ally of AMA’s in ICD-10 lobbying battles.
AMA’s strategy has yielded results. Its relationships and resources have postured it to be the most influential group in this debate, as evidenced by this latest HHS delay. Though it is yet to be seen whether or not the new compliance deadline will satisfy AMA, the group is well positioned long-term to handle any upcoming challenges its constituents may face.
Indeed, full implementation of ICD-10 is slated to take place on October 1, 2014 – but if groups like AMA adn perhaps others continue to lobby against implementation, future delays remain a possibility.
Alex Bronstein-Moffly is an analyst with the First Street Research Group in Washington, DC. The First Street Research Group reviews, investigates, and analyzes the data in First Street to publish reports and analysis on the people and organizations influencing policy in Washington, DC. Email: abmoffly@cqpress.com
More ICD-10 coverage:
If HHS delays ICD-10 just long enough, could the U.S. leapfrog to ICD-11?
Could ICD-10 have as big an impact as the mortgage crisis? Yes, here's why
ICD-10's ten-year reign of fear
3 pieces of the ICD-10 conversion to outsource -- and the 1 you cannot
