Friday, May 18, 2012

Meaningful Use Creep


One of the features of government is it’s inherent native ability to grow, creating a chain reaction of necessities for it’s survival.

Organizations always seem to add items piece by piece until a relatively simple idea becomes distorted.

Such now seems to be the case for meaningful use as defined by HHS for physicians to qualify for incentive payments.

GAO: Doctors should submit more data to get meaningful use money (amednews)


Hmm.  Isn’t GSA the outfit that went to Las Vegas ? Or was that the GAO?  Maybe they should check out their own house and stay out of Medicare’s business and healthcare decision making. There also appears to be some confusion in the details of who’s who in the debacle. Several sources used the term GAO and other used GSA. This investigator had some trouble finding the correct quotes made in the news.

The GAO has proposed new criteria for M.U. and in addition to that they propose new audits to  verify proper reporting by physicians in order to qualify for

Physicians soon could be required to submit more documentation to the Centers for Medicare & Medicaid Services to validate whether they are authorized to receive meaningful use bonuses.

Saying that the Medicare incentive program is vulnerable to making improper payments, the Government Accounting Office examined the process, called attestation, that CMS uses to validate whether physicians have met meaningful use requirements. The agency recommended that CMS examine its process for auditing the incentive program and collect more information from physicians before payments are made so they won’t have to return money to CMS.

CMS agreed that its process for verifying meaningful use eligibility could be made more efficient for the agency — and more stringent for those applying for incentive pay.

The current process, called ‘attestation’ depends upon

The Medicare incentive program is facilitated directly by CMS, and the Medicaid incentive program, like the Medicaid program, is administered at the state level. The GAO examined the eligibility and reporting requirements for the Medicare program, and the reporting and verification processes in four states that have a Medicaid incentive program up and running. As of March, 44 states had programs in place, and 40 had begun issuing incentive checks.

What needs verification

Medicaid requires additional reporting that Medicare either does not require or does not verify until after payment is made. The GAO would like to see the Medicare requirements expanded to match those of Medicaid.  One example is that to meet the requirement that data be sent electronically to an immunization registry or immunization information system, Medicaid program participants must submit the name of the registry where they sent data and whether it was sent successfully. Medicare participants are required only to attest that it was done.

CMS also agreed that it needed to evaluate its auditing process to ensure its effectiveness. Kuchler said its auditing program is being implemented and that a contract was recently awarded. It plans to start audits later in 2012.

About 10% of hospitals and 20% of professionals receiving incentive checks will be selected at random for auditing. Some also will be targeted for audits.  Kuchler said whatever CMS does with the GAO recommendations, it “is conscious of not adding unnecessarily to the burden providers face in reporting for this program and will certainly factor in the element of additional time in its determinations as we move forward.”

Among the GAO’s recommendations was for CMS to offer to collect quality measure data from Medicaid program participants on behalf of the states. But CMS rejected that recommendation, saying the states that have launched incentive programs already have portals in place and that there are no significant barriers to states collecting this information on their own.

It seems to Health Train Express and our new partner, Digital Health Space that MU reporting would be electronically be verified when the information is submitted via billing or through whatever means they propose to collect the data. If no one is going to receive the data or look at it, why report it? 

And as usual the fine print is

Physicians who received improper payments would have to return the money to CMS.

So, what else is new? 


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