NEW ORLEANS – Haven’t received your meaningful use incentive? Check your mail for an audit letter.
If in January you submitted an attestation of meaningful use of your electronic health record – with an eye to reaping the federal health IT incentive – an audit letter may be on its way to you.
A contractor for the Centers for Medicare and Medicaid Services began sending audit letters this week to randomly selected Medicare-eligible professionals and hospitals, Elizabeth Holland, a director of the HIT Initiatives Group in the agency’s Office of E-Health Standards and Services, said March 5 at the Healthcare Information and Management Systems Society annual conference. The audits could result in delays or ultimately, non-payment, she said.
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"We have a fiduciary responsibility to make sure that we are paying appropriately," Ms. Holland explained, adding that providers who were not selected for the audit have already received their payments.
Audit letters are being sent by Figliozzi & Co. to Medicare-eligible hospitals and physicians. If recipients do not respond, "their payment will be held up until they respond and provide the documentation" to back up their attestation, Ms. Holland said. "If a certain amount of time goes by and they still don’t respond, they will not be getting a payment."
These prepayment audits follow on the heels of postpayment audits that the CMS began in July 2012. Under that program, Figliozzi & Co. audited Medicare-eligible professionals and states audited Medicaid-eligible professionals.
Ms. Holland said that more than 2,000 postpayment audits are underway; some are random and some are targeted. The data generated by the audits is, and will be, used to modify the agency’s approach to meaningful use. For instance, one goal is to see whether providers are appropriately reporting measures, she said.
CMS also has found that professionals do not have the proper documentation to support what they are attesting to. In the next month, the CMS will issue guidance on what documentation is needed, Ms. Holland said.
She presented data showing that so far, 161,890 eligible professionals – out of 527,200 who are eligible – have attested to meaningful use. Most of those (161,677) did so successfully. About 200 were not successful.
Of the 5,011 hospitals that are eligible, 2,653 have been successful. None failed.
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