Why Physicians Must Be Aware of Meaningful Use Audits

Your meaningful use incentive payment may come with strings attached - in the form of an audit.

That’s according to attorney Robert Saner, principal at Powers Pyles Sutter & Verville PC, who
copresented a session at MGMA12 in San Antonio with attorney Amy Nordeng, counsel in the MGMA Government Affairs department.

“The government was all for it, they pushed the money out, and now they’re having second thoughts,” Saner said of the meaningful use incentive programs. He added that CMS has selected New York-based accounting firm Figliozzi and Co. to take on the role of auditing physicians and hospitals that have successfully attested.

The firm’s mission: To determine whether the payments received, were, in fact, earned.

Practices run the risk of being audited regardless of the specific incentive program in which they participated. Fizliozzi and Co. will audit recipients who received Medicare incentive payments and hospitals that received both Medicare and Medicaid incentives. In
addition, state-determined contractors will audit participants who received Medicaid payments only, according to American Medical News.

Saner said auditors are charged with looking at three key meaningful use-related areas:

1. Verifying whether the recipient’s EHR vendor was certified, according to the Office of the National Coordinator for Health Information Technology (ONCHIT) requirements.

2. Ensuring the vendor’s certification was adequate. Some practices may encounter trouble here, said Saner, noting that, a vendor’s certification may be based on a “whole suite of services” in the vendor’s package. If a practice did not purchase all of that vendor’s services, or if it only turned a few of them when attesting, it may not have attested using an ONCHIT certified vendor.

3. Determining whether the recipient actually satisfied both the core and menu set meaningful use criteria.

“If they decide your attestation was not appropriate and not properly documented, they’re going to want all the money back,” said Saner.

While being audited is never fun, law firm Ober Kaler said in a newsletter that the first audit letters sent out by Figliozzi and Co. “do not appear to be the type of specific, targeted, detailed investigation that can give rise to significant operational interruptions and expense.”

Still, the firm said, “It seems likely that the results of these broad, basic audits will be used by CMS as the basis for further audits under subsequent initiatives at a later date.”