HHS OIG to audit improper EHR incentive payments to hospitals
Agency updates Fiscal Year 2017 work plan calling for review of $14.6 billion in payments to identify potential Meaningful Use overpayments.
The Department of Health and Human Services’ Office of Inspector General has updated its Fiscal Year 2017 work plan to include a review of incentive payments made to hospitals for adopting electronic health records.
“We will review the hospitals’ incentive payment calculations to identify potential overpayments that the hospitals would have received as a result of the inaccuracies,” according to the OIG plan, which lays out the agency’s new and ongoing audit activities.
Auditors expect to issue a report on their findings in Fiscal Year 2018 based on Medicare EHR incentive payments, totaling $14.6 billion, made to hospitals from 2011 through 2016 by the Centers for Medicare and Medicaid Services.
Last month, an OIG audit found that CMS paid $729.4 million in improper incentive payments to eligible professionals who did not meet Meaningful Use requirements. The agency reviewed $6 billion in EHR incentive payments that CMS made to more than 250,000 EPs from May 2011 through June 2014.
Also See: CMS paid $729.4M in incorrect EHR incentive payments
“Previous OIG reviews of Medicaid EHR incentive payments found that state agencies overpaid hospitals by $66.7 million and would in the future overpay these hospitals an additional $13.2 million,” states the OIG. “These overpayments resulted from inaccuracies in the hospitals’ calculations of total incentive payments.”
In addition, auditors plan to review Medicare Part B payments for telehealth services, delivered via an interactive telecommunications system, which are covered by CMS, as long as certain requirements are met.
“To support rural access to care, Medicare pays for telehealth services provided through live, interactive videoconferencing between a beneficiary located at a rural originating site and a practitioner located at a distant site,” according to the OIG. “An eligible originating site must be the practitioner’s office or a specified medical facility, not a beneficiary’s home or office. We will review Medicare claims paid for telehealth services provided at distant sites that do not have corresponding claims from originating sites to determine whether those services met Medicare requirements.”
“We will review the hospitals’ incentive payment calculations to identify potential overpayments that the hospitals would have received as a result of the inaccuracies,” according to the OIG plan, which lays out the agency’s new and ongoing audit activities.
Auditors expect to issue a report on their findings in Fiscal Year 2018 based on Medicare EHR incentive payments, totaling $14.6 billion, made to hospitals from 2011 through 2016 by the Centers for Medicare and Medicaid Services.
Last month, an OIG audit found that CMS paid $729.4 million in improper incentive payments to eligible professionals who did not meet Meaningful Use requirements. The agency reviewed $6 billion in EHR incentive payments that CMS made to more than 250,000 EPs from May 2011 through June 2014.
Also See: CMS paid $729.4M in incorrect EHR incentive payments“Previous OIG reviews of Medicaid EHR incentive payments found that state agencies overpaid hospitals by $66.7 million and would in the future overpay these hospitals an additional $13.2 million,” states the OIG. “These overpayments resulted from inaccuracies in the hospitals’ calculations of total incentive payments.”
In addition, auditors plan to review Medicare Part B payments for telehealth services, delivered via an interactive telecommunications system, which are covered by CMS, as long as certain requirements are met.
“To support rural access to care, Medicare pays for telehealth services provided through live, interactive videoconferencing between a beneficiary located at a rural originating site and a practitioner located at a distant site,” according to the OIG. “An eligible originating site must be the practitioner’s office or a specified medical facility, not a beneficiary’s home or office. We will review Medicare claims paid for telehealth services provided at distant sites that do not have corresponding claims from originating sites to determine whether those services met Medicare requirements.”
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