Medicare paid about $729 million in improper payments as part of a program to reimburse doctors for investing in electronic health records (EHRs), according to a government audit.
During a three-year period starting in 2011, the Centers for Medicare and Medicaid Services (CMS) paid out more than $6 billion as part of a program to incentivize hospitals and physician practices to adopt electronic medical records, but many of the payments audited did not have sufficient justification.
CMS conducted “minimal documentation reviews” on doctors claiming payments as part of the program, “leaving the EHR program vulnerable to abuse and misuse of Federal funds,” the Office of the Inspector General wrote in its report.
To be eligible for EHR incentive payments, doctors must prove they are making “meaningful use” of electronic records systems, which means taking advantage of dozens of features designed to make health care more efficient.
The measures include things like using EHR software to automatically check how a patient’s prescribed medications interact with each other in proper doses, listing all of a doctors’ patients with the same condition, and sending automatic patient reminders. The doctors receiving the EHR payments must prove that they are properly making use of the records systems, but that didn’t always happen.
The inspector general looked at 100 cases of EHR payments, and found 14 of those either had incomplete documentation proving their eligibility, or were given EHR incentive payments for the wrong payment period. The inspector general found a total of $291,222 in improper payments, but the auditors estimate that given the size of the $6 billion program, the actual total would be close to $729 million.
The new administration “is committed to turning the page and ushering in a new era of accountability,” CMS officials said in a response to the audit report. “Providing high-quality care to Medicare beneficiaries while being responsible stewards of taxpayer dollars remains a top CMS priority, and we recognize the value data validation and auditing bring to our programs.”
The audit report suggests that CMS recover the $291,222 already disbursed, and review all the payments made to ensure the government hasn’t wasted more taxpayer money.
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