Meaningful Use Audits Delay Payment of Some EHR Bonuses

March 19, 2013 12:05 am Sheri Porter

Some family physicians who have purchased and implemented an electronic health record (EHR) system and attested to meaningful use of that EHR may be subjected to an audit before they see a bonus check. That's the word from CMS' Office of E-Health Standards and Services.

[Word graphic showing Audit along with other related terms]

This most recent round of audits, dubbed "prepayment audits," is in addition to postpayment meaningful use audits that were initiated in the summer of 2012.

According to Elizabeth Holland, director of CMS' Health IT Initiative Group (a department overseen by the e-health standards office), between 5 percent and 10 percent of all eligible professionals attesting for meaningful use will be selected for prepayment audits.

"Selections will be made both randomly and also based on protocols that identify suspicious or anomalous attestation data," said Holland. Postpayment audits will affect another 5 percent to 10 percent of physicians and other health care professionals.

Story Highlights

  • As many as 10 percent of physicians and other health care professionals who attested to EHR meaningful use may be selected for a prepayment audit of their application.
  • Physicians who receive an audit letter from Figliozzi & Co. should respond immediately to prevent further delays in payment.
  • Not all physicians waiting for bonus checks are stuck in the audit queue; their payments likely still are being processed by CMS.

The scope of both audit programs "is consistent with the scope of audit strategies for similar CMS programs," Holland said.

The most recent public report from CMS on the incentive programs(www.cms.gov) -- current through Jan. 31 -- indicates that to date, 206,982 eligible professionals have been paid an EHR meaningful use bonus. That figure comprises payments made through Medicare (122,632), Medicare Advantage (11,117) and Medicaid (73,233).

A total of 527,300 physicians and other health care professionals are eligible to participate in the EHR incentive programs, said Holland.

Physicians selected for an audit will receive a letter from Figliozzi & Co.(questions.cms.gov), a certified public accountant firm based in Garden City, N.Y., and selected by CMS in April 2012 to conduct audits associated with the programs.

According to Holland, any physician who receives an audit letter should respond to the request immediately because the bonus will be held until the physician passes the audit review.

Not all physicians waiting for bonus checks are stuck in the audit queue, however; a good number of payments still are being processed by the government.

CMS has made available a list of frequently asked questions(questions.cms.gov) the agency receives about audits related to the EHR incentive programs.


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