OIG: Louisiana Made $4.4M in Incorrect EHR Incentive Payments

September 10, 2014 in News

Louisiana’s Department of Health and Hospitals made millions of dollars in incorrect electronic health record incentive payments under the Medicaid meaningful use program to both hospitals and doctors, according to an HHS Office of Inspector General report, Modern Healthcare reports.

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments.

Audit Findings

For the audit, federal officials examined the state’s 25 highest paid hospitals under the program. The audit showed the hospitals received a combined total of nearly $53.2 million in meaningful use incentive payments.

However, the audit showed that 13 of the hospitals received overpayments totaling $3.1 million, while six hospitals were underpaid by about $1.3 million.

In a release, OIG said one incorrect payment to an additional hospital was identified and recovered by the state during the audit.

In addition, the audit found that the state agency made incorrect EHR incentive payments to 13 eligible professionals, totaling $3,250 (Conn, Modern Healthcare, 9/9).

In the report, OIG identified six main reasons for the incorrect payments:

  • Agency officials’ failure to reconcile the CMS-64 report with the CMS National Level Repository;
  • An error in the formula used to calculate the discharge-related amounts on the hospital calculation worksheet;
  • Clerical errors made by state agency workers;
  • Errors in the cost reports or supporting documents that were used to calculate incentive payments;
  • Failure by the state agency to have system edits in place to catch overpayments to professionals; and
  • Louisiana’s instructions on hospital incentive payments and patient-volume calculations contained incorrect or inadequate information.

Recommendations

OIG recommended that the state agency:

  • Readjust the remaining incentive payments of the improperly paid hospitals and professionals to reflect the errors;
  • Refund the overpayments to CMS;
  • Revise its calculation worksheets and other documentation to correct formula errors; and
  • Work with CMS to create policies that will correctly reconcile information with the NLR (Bresnick, EHR Intelligence, 9/9).

According to the report, Louisiana’s Department of Health and Hospitals agreed with the recommendations and is taking action to address the errors and repay CMS (AP/Washington Times, 9/9).

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