OIG plans to investigate $15 billion in meaningful use payments
The Department of Health and Human Services Office of Inspector General will review the accuracy of $14.6 billion in meaningful use payments made to hospitals by Medicare between 2011 and 2016. Earlier this year, the OIG estimated physicians were wrongfully paid $729 million under meaningful use.
Medicare incentive payments were authorized over a 5-year period to hospitals that adopted electronic health record technology. From January 1, 2011, through December 31, 2016, the Centers for Medicare and Medicaid Services made Medicare EHR incentive payments to hospitals totaling $14.6 billion, the OIG said.
The Government Accountability Office identified improper incentive payments as the primary risk to the Medicare EHR incentive program. An OIG report described the obstacles that CMS faces in overseeing the Medicare EHR incentive program. In addition, previous OIG reviews of Medicaid EHR incentive payments found that state agencies overpaid hospitals by $66.7 million and would in the future overpay these hospitals an additional $13.2 million, the OIG said.
“These overpayments resulted from inaccuracies in the hospitals’ calculations of total incentive payments,” the OIG said. “We will review the hospitals’ incentive payment calculations to identify potential overpayments that the hospitals would have received as a result of the inaccuracies.”
On another front, the OIG will be reviewing the accuracy of telemedicine payments under Medicare.
Medicare Part B covers expenses for telehealth services on the telehealth list when those services are delivered via an interactive telecommunications system, provided certain conditions are met. To support rural access to care, Medicare pays for telehealth services provided through live, interactive videoconferencing between a beneficiary located at a rural originating site and a practitioner located at a distant site.
“An eligible originating site must be the practitioner’s office or a specified medical facility, not a beneficiary’s home or office,” the OIG explained. “We will review Medicare claims paid for telehealth services provided at distant sites that do not have corresponding claims from originating sites to determine whether those services met Medicare requirements.”