AAFP Raises Concerns Over Ongoing Meaningful Use Program Audits

April 11, 2015 in News

This week, the American Academy of Family Physicians sent a letter to CMS acting Administrator Andy Slavitt raising concerns that meaningful use program audits could be causing an undue hardship for family medicine and primary care physicians, EHR Intelligence reports.

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments (Gruessner, EHR Intelligence, 4/9).


Earlier this month, HHS’ Office of Inspector General began auditing meaningful use payments made to eligible professionals as part of its fiscal year 2015 work plan.

According to OIG spokesperson Donald White, the audits are being conducted to determine whether CMS is appropriately using taxpayer funding, rather than to identify fraudulent reporting by eligible professionals.

However, White added that if “auditors come across information that might involve enforcement issues, they might provide that information to CMS or OIG” (Terry, Medscape, 4/2).

Daniel Gottlieb, a lawyer with McDermott Will Emery, said that providers will have to repay incentives if OIG finds that they have received inappropriate payments.

According to FierceEMR, OIG has completed audits of the Medicaid meaningful use programs in Florida and Massachusetts and has started a separate audit in Pennsylvania (Durben Hirsch, FierceEMR, 4/6).

Meanwhile, an external auditor for CMS has been reviewing all incentive payments made since 2012 (Medscape, 4/2).

Details of Letter

In the letter, AAFP Board Chair Reid Blackwelder questioned the qualifications of the individuals conducting the meaningful use program audits.

Specifically, he said the auditors do not seem to have backgrounds in health IT or EHR implementation, which has caused miscommunication and taken time away from doctors that they otherwise would spend treating patients.

Further, Blackwelder raised concerns about requiring physician practices to repay their incentives if they are missing even one piece of documentation required for the reviews. He said the policy has led to delays in eligible professionals’ health IT implementations and upgrades.

In addition, AAFP said EHR vendors are unaware of the auditing program’s documentation requirements, causing further problems.

AAFP called on CMS to compile a report on meaningful use audits that includes information on the:

  • Failure rate of audits and the specific data that led to the failure; and
  • Number of audits conducted.

The letter said, “If the government believes that a strong primary care foundation is the key to an improved and sustainable health care system, then we urge you to take these issues into account and provide immediate and increased relief to those who have acted responsibly and legally and had no intent to defraud or deceive by participating in the meaningful use program” (EHR Intelligence, 4/9).

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