CMS has launched prepayment audits for certain health care providers who have attested to the meaningful use of electronic health record systems, FierceEMR reports (Durben Hirsch, FierceEMR, 3/24).
Background
Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHR systems can qualify for Medicare and Medicaid incentive payments.
In November 2012, HHS’ Office of Inspector General released a report that criticized CMS for poor auditing of the incentive program.
OIG’s report recommended that CMS strengthen its prepayment assessment program by randomly selecting “high-risk” providers and asking them to “submit supporting documentation for prepayment review” (iHealthBeat, 11/29/12).
Details of Audits
Elizabeth Holland — director of the Health IT Initiatives Group in CMS’ Office of E-Health Standards and Services — said that CMS is conducting prepayment audits of 5% to 10% of providers who attested to meaningful use in January (FierceEMR, 3/24).
She said that prepayment audit selections were “made both randomly and also based on protocols that identify suspicious or anomalous attestation data.”
Holland said that an additional 5% to 10% of meaningful use attesters will undergo post-payment audits.
New York-based accounting firm Figliozzi & Company — which was chosen by CMS to conduct the audits — is sending letters notifying health care providers who have been selected for audits.
According to Holland, providers who receive a letter should respond to it immediately because meaningful use incentives will be withheld until providers pass the audit review (Porter, AAFP News Now, 3/19).
Source: iHealthBeat
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