Look Out for Meaningful Use Audits by the Office of Inspector General

The Medicare and Medicaid Electronic Health Care Record (“EHR”) Incentive Program (commonly referred to as “Meaningful Use”) provides incentive payments to eligible physicians and hospitals for adopting, implementing, upgrading, or demonstrating meaningful use of certified EHR technology.  Medicare incentive payments are authorized over a 5-year period (2011 through 2016).  As of February 2015, total EHR incentive payments exceeded $29.5 billion.

Meaningful Use payments were identified as an area of review by the Office of the Inspector General of the Department of Health and Human Services (“OIG”) in its fiscal year 2015 Work Plan. The Work Plan states that the OIG will review Medicare incentive payment data dating back to 2011 to identify payments to providers that should not have received incentive payments, such as those not meeting selected Meaningful Use criteria.  The Work Plan also provides that the OIG will review Medicaid incentive payments to Medicaid providers and hospitals and determine whether incentive payments to purchase, implement, and operate EHR technology were claimed in accordance with Medicaid requirements.  The Work Plan further states that the OIG will perform audits of various covered entities and their business associates (such as EHR cloud service providers) to determine whether they adequately protect electronic health information created or maintained by certified EHR technology.

Although the Centers for Medicare and Medicaid Services have been conducting Meaningful Use audits through a subcontractor for several years, recent reports indicate that audits by the OIG are now underway.  If you have any questions about Meaningful Use compliance, or if you are subjected to an audit, members of the Parker Poe Health Care Practice Group are available to assist you.

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