report published on June 12, 2017, the HHS Office of Inspector General (OIG)
recommended that the Centers for Medicare and Medicaid Services (CMS) attempt
to recover an estimated $729 million in electronic health record (EHR)
incentive payments paid to eligible healthcare professionals (EPs) who were not
compliant with Federal requirements. EPs
include doctors, dentists, podiatrists, optometrists and chiropractors.
paid over $6 billion in incentive payments to EPs who attested to “meaningful
use” of EHR technology. OIG conducted
its review to determine if CMS exercised effective oversight over the
on a review of a random sample of 100 EPs, OIG determined that 14 EPs received
payments totaling $291,222 despite failing to meet meaningful use
requirements. OIG extrapolated that
amount to estimate overpayments to EPs at $729 million. In addition, $2.3 million in overpayments are
the result of EPs receiving both Medicare and Medicaid EHR incentives in the
same year in violation of program rules.
CMS will work with its EHR incentive program audit
contractor to recover the identified overpayments from the sampled EPs who did
not meet meaningful use requirements.
CMS will pursue additional overpayments from EPs based on
CMS will recover $2.3 million from identified EPs who
received both Medicare and Medicaid EHR incentive payments in the same year.
EPs should ensure that they meet all applicable requirements
for EHR incentive payments, and return any identified overpayments within 60
days as required by law.
health care practice group at Plews Shadley Racher & Braun LLP regularly
works with physicians, dentists, nurses, physician assistants, and other health
care providers to counsel on FCA and other regulatory issues. Additional information about Plews Shadley
Racher & Braun LLP and its health care practice is available at www.psrb.com.
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