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29-11-2012 | Article

Report spots payment leaks in electronic health record incentives

Abstract

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medwireNews: Despite $ 4 billion being spent on the introduction of Medicare electronic health records (EHR), the Centers for Medicare and Medicaid Services (CMS) has failed to properly supervise their "meaningful use" by providers who receive incentive payments to fulfill their end of the deal, federal investigators have concluded.

"CMS faces obstacles to overseeing the Medicare EHR incentive program that leave the program vulnerable to paying incentives to professionals and hospitals that do not fully meet the meaningful use requirements," writes Daniel Levinson, Inspector General of the Department of Health and Human Services (HHS), Washington DC, in a report. "CMS should consider ways to strengthen its program oversight to protect… billions of dollars in payments."

The 2009 Health Information Technology for Economic and Clinical Health Act (HITECH Act) established funding opportunities for eligible healthcare providers to adopt a standardized EHR system. To earn incentive payments, doctors and hospitals must follow criteria as stipulated by the CMS and ensure health information is exchanged in a manner that improves healthcare quality, safety, and efficiency.

Between 2011 and 2016 the CMS will spend $ 6.6 billion on Medicare EHR incentive payments. Health professionals receive up to $ 44,000 over the span of the program while hospitals can receive a minimum of $ 2 million per year.

The HHS report points out that the CMS has failed to verify - prior to payment - whether professionals' and hospitals' self-reports on meaningful use of EHR technology are accurate. Preemptively verifying this information, it suggested, would avoid the risk for pursuing invalid payments.

The CMS has also failed to collect enough data and documentation to monitor the standard of self-reports of EHR use, the report says. This gap in information, the report concludes, makes it problematic for the CMS to conduct audits of payments already made.

The CMS agreed with the HHS's recommendation to improve communications with healthcare providers about the type of documentation that is required to gauge the use of EHR. Yet CMS did not concur with the suggestion of prepayment reviews, noting that it would burden practitioners and hospitals and possibly delay needed incentive payments.

The Office of the National Coordinator for Health Information Technology, which established the certification of EHR systems, was also urged to update EHR technology to assist in reporting compliance in an accurate and user-friendly manner.

By Peter Sergo, medwireNews Reporter