Revenue Cycle Management Blog | GroupOne Health Source

Meaningful Use: Pre-Payment Audits in 2013

Written by Kaitlyn Houseman | April 12, 2013

It’s not just about demonstrating Meaningful Use in 2013.  CMS will now be performing pre-payment audits in addition to the post-payment Meaningful Use audits.  Before mailing out some bonus checks, CMS says the audits (which will affect 5-10% of incentive applications) will be random and start with attestations submitted during and after January 2013.

According to the CMS, the pre-payment audits may target suspicious or anomalous data. Providers selected for audits will have to provide data to support their attestation or validate their submitted data before CMS will release their bonus payment.

Providers selected can anticipate an electronic letter from CMS’ contracted CPA firm, Figliozzi & Co.  The initial review process will follow and use information provided in response to the request letter.  An on-site review may be necessary in some cases and would require a demonstration of the EHR system. 

An appeals process is available for all EPs, eligible hospitals, and CAHs.  A toll free number is provided on the CMS website which will offer answers on how to file appeals and the status of any pending appeals.  The appeals processes for the Medicaid EHR Incentive Program will be determined by each state.

As of the end of February, Government Health IT reports an estimated $12.3 billion in meaningful use incentive payments had been distributed to 219,000 eligible hospitals and health care professionals.

According to the latest data, in February a total of $725 million was paid out to 33,090 health care providers. That total includes:

  • $425 million in Medicare incentive payments distributed to 27,500 eligible professionals;
  • $200 million in Medicare and Medicaid incentive payments distributed to 90 eligible hospitals; and
  • $100 million in Medicaid incentive payments distributed to 5,500 eligible professionals.

From the inception of the meaningful use program through February:

  • 140,000 eligible professionals received Medicare incentive payments;
  • 75,500 eligible professionals received Medicaid incentive payments; and
  • 3,757 eligible hospitals received Medicaid and Medicare incentive payments.

If your EHR is making meaningful use difficult and time consuming for your practice maybe it is time to consider a few others.  Click here to learn how you can join the large network of  eClinicalWorks users who have already successfully attested.