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CMS offers audit advice

August 12, 2013

Health care practitioners audited for compliance with federal government’s Electronic Health Records (EHR) Incentive Program meaningful use standards must keep two important concepts in mind: cooperation and documentation.

Centers for Medicare & Medicaid Services (CMS) officials are making efforts to help health care practitioners understand the audit program. They offered a June webinar and interview with health care media.

While acknowledging many health care practitioners may be “unsettled” by the prospect of an audit, Elizabeth Holland, director of the Health Information Technology (HIT) Initiatives Group within CMS’ Office of E-Health Standards and Services, advised those who receive audit notices “to not panic, and always tell the truth.”

This year the CMS implemented pre-payment audits on Medicare and dually eligible (Medicare and Medicaid) providers participating in the EHR Incentive Programs. This audits complement post-payment audits the CMS introduced in 2012.

Both audit programs target between 5 percent and 10 percent of eligible professionals attesting to meaningful use, according to Holland.

Both the pre-payment and post-payment audit programs will be in place for the duration of the EHR Incentive Programs.

Health care practitioners will be notified by letter if they are the subject of an audit.

Practitioners who receive an audit letter have two weeks to respond. However, practitioners can request an extension.

In most cases, practitioners should have on hand most of the materials required for the audit. Auditors, for the most part, will request documentation practitioners must prepare in order to attest meaningful use.

The CMS offers an audit overview, a fact sheet explaining the documentation required to support meaningful use attestation, and other resources online. Practitioners should review the documentation guidelines to determine what materials they should retain in their records.

The CMS’ EHR audit program webinar is available at www.cms.gov/ehealth.

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