One in 20 Meaningful Use Attesters To Face Audits, Official Says

About one in 20 participants in the meaningful use program can expect to face  an audit for compliance with the program’s requirements, according to a CMS  official, Modern Healthcare reports.

Background

Under the 2009 federal economic stimulus package, eligible hospitals and  health care professionals who demonstrate meaningful use of certified electronic  health record systems can qualify for Medicare and Medicaid incentive  payments.

Since October 2012, CMS has conducted audits of meaningful use program  participants who have received incentive payments.

In January, CMS started conducting prepayment audits of health care providers  who attested to the meaningful use of EHR systems.

CMS Official’s Comments

During a telephone update on CMS’ meaningful use audits, Robert Anthony —  deputy director of CMS’ Health IT Initiatives Group — said that CMS aims to  audit about 5% of all meaningful use program participants by conducting  approximately the same amount of prepayment and post-payment audits.

He added that Figliozzi & Company, CMS’ audit contractor, will conduct  the majority of reviews through “desk audits” but that a few on-site audits  could occur.

Anthony said CMS so far has sent few letters notifying health care  providers about adverse audit findings. However, he noted that the agency still  is in the early stages of its auditing efforts. He added that a few health care  providers with adverse audit notices are starting the appeals process and that  some providers are facing investigation for possible fraud.

According to Anthony, the most common problems identified in the audits so  far are:

• Noncompliance with the requirement that health care providers conduct a data  security risk assessment, which also is a requirement under HIPAA; and
• A lack of adequate documentation to support responses to some of the “yes or  no” meaningful use requirements, such as whether an EHR system has been tested  for the ability to exchange clinical data (Conn, Modern Healthcare,  4/22).

Source: iHealthBeat

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