The Centers for Medicare and Medicaid Services (CMS) has started auditing some healthcare providers before giving them Meaningful Use incentive payments. According to the agency’s Office of E-Health Standards and Services, prepayment audits are being conducted on between five and ten percent of providers who attested to Meaningful Use of their certified Electronic Health Records systems in January 2013.
Last November, the Office of the Inspector General of the Department of Health and Human Services (HHS) criticized CMS in a report, noting poor auditing of the EHR incentive program, affirming a similar charge by the U.S. General Accountability Office (GAO) several months earlier. While “postpayment audits” commenced in the summer of 2012 and can result in payments being recouped, CMS eventually opted to follow OIG’s recommendation for prepayment audits, despite initially arguing that this would be an additional burden on healthcare providers. Providers will be selected “based on protocols that identify suspicious or anomalous attestation data,” though some providers will also be chosen at random; they will receive a letter from New York-based accounting firm Figliozzi & Company, chosen by CMS as a contractor to conduct the audits. Anyone receiving such a letter (sent electronically to the E-mail address provided during registration for the incentive program) will not receive an incentive payment until passing the audit review, so an immediate response is strongly advised.
CMS states on its FAQs page that all providers attesting for either the Medicare or Medicaid EHR incentive programs should retain all relevant supporting documentation, in either paper or electronic format, used in the completion of the Attestation Module responses for six years, as well as documentation supporting the values entered in the Attestation Module for Clinical Quality Measures. The initial review process for the Medicare program will be conducted at Figliozzi & Company’s offices using the documentation received from the provider, although additional documentation and a subsequent on-site review at the provider’s location may be required, possibly even including a demonstration of the EHR software.
According to CMS’ latest public report on the incentive programs, as of January 31, 2013, almost 207,000 eligible healthcare providers (and over 3,500 eligible hospitals) have received an EHR Meaningful Use payment; this number still represents less than half the number of healthcare professionals (nearly 530,000) eligible to participate in the programs. More than $3.7 billion has already been paid out to eligible professionals since payments began in 2011, and another $7.9 billion to eligible hospitals. Meanwhile, the GAO reported in December that the prepayment audits could save Medicare almost $115 million, an important consideration when federal government spending is being closely scrutinized.
A certified EHR system such as McKesson Practice Choice or Medisoft Clinical can help you not only achieve Meaningful Use and receive incentive payments but also improve your practice’s efficiency, patient care, and financial performance. Please contact Microwize Technology for more information.
