The U.S. Centers for Medicare and Medicaid Services (CMS) has published guidance documents on audits for the meaningful use electronic health record (EHR) incentive program.
The audits of Medicare providers are being conducted by Figliozzi and Company -- a CMS contractor -- while individual state government agencies or their designated contractors will perform audits of providers participating in the Medicaid incentive program.
Audits of healthcare provider organizations and eligible providers that have received meaningful use incentive payments began in 2012. CMS announced that in 2013 it will begin to conduct prepayment audits. These will start with attestations submitted during and after 2013.
The prepayment audits will be random and may target suspicious or anomalous data, according to CMS. Providers selected for prepayment audits will be required to present supporting documents to validate submitted attestation data before CMS will make a payment.
All healthcare providers are expected to retain documentation in electronic or paper format for a period of six years. This includes documentation that supports attestation data for meaningful use objectives and clinical quality measures, as well as documents to support payment calculations.
Healthcare organizations and eligible providers will be notified by an email containing a letter advising that they have been selected for an audit and will provide Figliozzi and Company's contact information. The initial phase of the audit will be conducted remotely but may be followed with an on-site review that includes a demonstration of the EHR system or module(s) being utilized.
General information about the audit process may be accessed here. A detailed explanation of the documentation required may be accessed here.
