Report Finds Medicare EHR Incentive Program Vulnerable to Abuse
The federal program promoting the use of electronic health records (EHRs)—and charged with doling out billions of dollars to encourage hospitals, doctors’ offices and other healthcare facilities to do so—is vulnerable to waste and abuse, according to a new report that calls for more stringent reviews before payments are handed out.
The so called 'meaningful use' incentive program awards money to medical facilities and offices that convert to and utilize EHRs. A total of $6.6 billion in Medicare EHR incentive payment is expected to be handed out, with more than half of that already distributed. The problem, according to the report from the Office of the Inspector General with the Department of Health and Human Services, is that there are few, if any safeguards in place to actually ensure that recipients of the money are doing what they’re supposed to be doing. The report focused on the work of the Centers for Medicare & Medicaid Services and its oversight of the Medicare program.
“Currently, CMS has not implemented strong prepayment safeguards, and its ability to safeguard incentive payments postpayment is also limited,” says the report, which comes at a time when many hospitals are struggling with how best to move toward EHRs. And it comes in a political environment marked by Republican unease with the incentive program. Even before the report came out, congressional Republicans had been raising questions about possible fraud in the program.
The move to EHRs, strongly supported by the Obama administration, is a linchpin of a broader healthcare reform effort. Supporters say EHRs will ultimately improve efficiency and patient care. Critics say the program is moving forward with little clear direction, few checks on quality, and insufficient attention to issues such as patient privacy and security of these records from cyberthreats.
The report recommends that:
- CMS obtain and review supporting documentation from selected professionals and hospitals prior to payment to verify the accuracy of their self-reported information.
- CMS issue guidance that details the types of documentation it expects professionals and hospitals to maintain to support their compliance.
- The Office of the National Coordinator for Health Information Technology (ONC) require certified EHR technology to be capable of producing reports for yes/no meaningful use measures, where possible.
- ONC improve the certification process for EHR technology to ensure accurate EHR reports.
To download a copy of the Inspector General’s full report, which includes comments from the agencies, click here (PDF).
Posted: November 29, 2012