CMS ramps up incentive program audits


Last November, the Office of the Inspector General (OIG) took the Department of Health & Human Services to task for not doing enough to make sure meaningful use incentive payments were going to deserving providers.

As this New York Times article summed it up at the time, the OIG report said that “Medicare, which is charged with managing the incentive program that encourages the adoption of electronic records, has failed to put in place adequate safeguards to ensure that information being provided by hospitals and doctors about their electronic records systems is accurate.”

That’s about to change, officials at the Centers for Medicare & Medicaid Services (CMS) are now saying.  According to this article, Elizabeth Holland, director of CMS' Health IT Initiative Group, has announced that “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. "Post-payment audits will affect another 5 percent to 10 percent of physicians and other healthcare professionals.”

Naturally, an audit is going to hold up any actual incentive payments, so officials are saying that any provider who receives a letter from Figliozzi & Co., "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,” should reply as soon as possible.

In the meantime, CMS has made available a list of FAQs for providers who want to prepare for an audit, just in case.

More information can be found here.