Warning: CMS to audit 5 percent of EHR program participants

July 13, 2013

The U.S. Centers for Medicare & Medicaid Services (CMS) plans to audit about one in every 20 participants in its electronic health record incentive payment programs for compliance with meaningful use criteria and other program rules, according to the Modern Healthcare website. The CMS launched its new EHR auditing program in January.

The auditing program covers practitioners who have attested compliance with the meaningful use standards and received incentive payments as well as those who have attested but are still awaiting payment.

So far, the audits have uncovered relatively few problems, CMS officials report. The most common involve failure to conduct a complete data security risk assessment – a step required under both the CMS meaningful use criteria and the federal Health Insurance Portability and Accountability Act (HIPAA).

These audits may lead to complete HIPAA compliance investigation.

Lack of adequate documentation for “yes or no” questions in the EHR meaningful use attestation process has been another common problem, according to the CMS. For example, when providers test an EHR for clinical data exchange, they must be able to document whether or not the test was successful.

The program involves mostly “desk audits” in which information is exchanged electronically. However, the CMS may conduct a few on-site audits.

The audits are being conducted under contract by the accounting firm, Figliozzi and Co.

AOA members can find detailed information on the Medicare and Medicaid EHR incentive programs online.

Visit www.aoa.org/ehr to view the steps required for compliance with the CMS EHR meaningful use standards and to register for the AOAExcel™ EHR and Medical Records Compliance Program course.

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