News Feature | September 27, 2013

When You Fail Your Meaningful Use Audit

Source: Health IT Outcomes
Greg Bengel

By Greg Bengel, contributing writer

HTO Frustrated Doctor

At a recent webinar, CMS explains what happens to funds when a provider fails a meaningful use audit, as well as how it affects that provider’s further role in the incentive program

Have you ever wondered what happens exactly when a provider participating in the EHR Incentive Program fails a meaningful use audit? If you are a provider participating in the program, odds are your philosophy is something akin to I-don’t-know-and-I-don’t-plan-on-finding-out. But still, it’s a good question. What happens to the disbursed incentives? How does the failed audit affect the provider? Does it have any impact on that provider’s future participation in meaningful use?

An audience member at CMS’s webcast on Medicare and Medicaid EHR Incentive Programs, which took place during National Health IT Week, posed the question to Travis Broome, the Team Lead for Policy and Oversight of Health Information Technology Initiatives at CMS. An article from EHR Intelligence recorded Broome’s response.

According to Broome, when a provider fails an audit, “The funds are being recouped. They are not taken away from future pieces. There is a demand letter that is sent when audit is failed within certain timeframes. At after 30 days, it’s just the write-the-check version — no interest, no claims adjustments, no treasury involvement and all that stuff — just write us a check back. After that, it gets transferred from EHR incentive debt to a more traditional Medicare debt, and then it gets turned over to that more traditional side of Medicare and goes through interest and possibly docking claims and all that stuff that more traditional Medicare stuff does.”

The follow-up question inquired about the impact of a failed meaningful use audit on a provider’s further involvement in the program. Broome’s answer to this question, too, is supplied by EHR Intelligence. “If you fail an audit, say, by 2 percent or something and it just turned out that you ran the numbers wrong or whatever, you do lose that year of meaningful use, but … there are many years and each year is independent,” the article quotes. “So let’s say I started out in 2011 and I failed an audit in 2011 and returned $18,000. If I came in 2012 and everything worked out and I passed, I would get $12,000. If I come back in 2013, I would get $,8000; 2014, $4,000; etc., etc. An audit only affects that one year.”

An article on quotes Mac McMillan, healthcare IT security expert and president of CynergisTek on meaningful use audits. According to the article, 80 percent of providers (47 out of 59) failed audits conducted in April of 2012. However, the article points out, given that HIPAA rules have been around for a decade, complying with stage 1 and 2 meaningful use requirements should not be that difficult. “They are exactly the same,” McMillan is quoted. “If you are complying with the HIPAA rules, you are complying with the MU rules.”

Check out this article from Physicians Practice for tips on how you can prepare for a Meaningful Use audit.