A report issued Nov. 29 by the Office of the Inspector General calling for more oversight of the meaningful use program has been mostly well-received by stakeholders. Doctors, however, are concerned about the burden of pre-payment audits.
Doctors against MU pre-pay audits
"We oppose prepay audits in the meaningful use program, as they would impose additional burdens on physicians who already face separate program requirements for multiple Medicare health IT and quality programs," said American Medical Association Board Chair Steven J. Stack, MD. He added, however, that the AMA "supports the OIG's other recommendations."
"We agree that CMS should issue clear guidance about the types of documentation physicians must maintain to support their compliance with the meaningful use program," Stack said. "We also support the recommendation that ONC improve the certification process for EHR technology and require certified EHR technology to produce compliant and accurate reporting documents."
[See also: OIG wants better oversight of MU.]
In the report, the Centers for Medicare & Medicaid Services also disagreed with prepay audits, citing the burden on physicians.
Other stakeholders back oversight – purely as a routine part of fiscal responsibility over any federally funded program – but were quick to point out that there has been no evidence of providers fraudulently reporting.
David Kibbe, MD, senior advisor to the American Academy of Family Physicians, said he would agree that CMS needs to do a better job of overseeing the MU incentive program.
"It is simply common sense that the spending of this much money ought to be accompanied by closer supervision, including audits," he said. "I'd add that there is also a need for CMS to do a better job of assisting healthcare providers, especially phyisians in small practices, to spend this money wisely and to get the features and functions from the EHRs they need to do quality improvement."
Linda Fishman, senior vice president of public policy analysis and development at the American Hospital Association, said, "The OIG report contains no evidence of improper payments."
"Hospitals take seriously their obligations to provide accurate reports to Medicare, and are working diligently to comply with the highly complex regulatory requirements in the meaningful use program," she said. "In addition, CMS is currently conducting audits of hospitals that have received meaningful use payments."
[See also: Meaningful use Stage 2 crunch starts now.]
The report also called for the Office of the National Coordinator for Health Information Technology to alter the EHR certification requirements to include yes/no reporting capabilities for meaningful use.
"I think it’s worth noting that the OIG report does not reveal any inappropriate payments nor does it insinuate they necessarily exist," said Justin Barnes, vice president of marketing, industry and government affairs at Greenway Medical Technologies. "Its central point is a matter of considering the establishment of any necessary financial oversight as the meaningful use program advances."
"If federal agencies can determine agreeable oversight – if necessary – as well as what eligible providers and hospitals need to put into place to document incentive funding and eligibility, I think that type of future transparency will benefit the entire system, but I don’t believe that retroactive audits would find any issues with either the Medicare or the Medicaid pathway funding," he added.