Office of the Inspector General MU Report

In this month’s post, we take a look at the HHS Office of the Inspector General’s (OIG) early (November 2012) assessment of the CMS oversight of the Medicare EHR Incentive Program. The following is an excerpt from the executive summary of the report, Early Assessment Find That CMS Faces Obstacles In Overseeing The Medicare EHR Incentive Program (OEI-05-11-00250).

Why did the OIG do this study?

This study is an early assessment of CMS’s oversight of the Medicare electronic health record (EHR) incentive program, for which CMS estimates it will pay $6.6 billion in incentive payments between 2011 and 2016. Because professionals and hospitals self- report data to demonstrate that they meet program requirements, CMS’s efforts to verify these data will help ensure the integrity of Medicare EHR incentive payments.

How did the OIG do this study?

This study reviewed CMS’s oversight of professionals’ and hospitals’ self-reported meaningful use of certified EHR technology in 2011, the first year of the program. To address our objective, OIG analyzed self-reported information to ensure it met program requirements. OIG also reviewed CMS’s audit planning documents, regulations, and guidance for the program, and conducted structured interviews with CMS staff regarding CMS’s oversight.

What did the OIG find?

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. Currently, CMS has not implemented strong prepayment safeguards, and its ability to safeguard incentive payments postpayment is also limited. The Office of the National Coordinator for Health Information Technology (ONC) requirements for EHR reports may contribute to CMS’s oversight obstacles.

To read the entire report, and learn about the OIG’s recommendation, go to https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp

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