Medicare’s Costly Mistake

Medicare paid $729 million to doctors and health workers improperly.

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A recent U.S. Department of Health and Human Services Office of Inspector General audit found that over three years, Medicare improperly paid health professionals who said that they earned initiative payments, but failed to provide proof or meet bonus criteria.

The payments were paid under the meaningful use initiatives, which was created to accelerate the use of electronic health records.

How did this happen?

CMS alleged that eligible providers didn’t maintain support for their attestations.

CMS also did not conduct minimal documentation reviews to ensure that providers were meeting requirements.

OIG has recommended that CMS return the $291,000 payments to the sampled providers that did not meet meaningful use requirements and attempt to recover the $729 million in improper incentive payments.

What will CMS do in the future?

CMS stated that it has implemented targeted risk-based audits to strengthen the program.

OIG has warned that this is insufficient, and that CMS should also engage education to help providers understand the required documentation for incentive programs.

Let us know what you think!

How should CMS fix its mistake? Were you impacted by the CMS mistake when obtaining meaningful use?

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