Filed Under:Health Insurance, Individual Health

Watchdogs to feds: You're too trusting

HHS OIG officials said verification problems could affect the integrity of Medicare EHR incentive payments.
HHS OIG officials said verification problems could affect the integrity of Medicare EHR incentive payments.

Trusting doctors, hospitals and providers' vendors to report accurately and honestly on how well the providers are using electronic health record (EHR) technology might be cheap and easy, but it's a bad idea.

Officials at the Office of the Inspector General at the U.S. Department of Health and Human Services (HHS OIG) made that argument in a report on the challenges that the Centers for Medicare & Medicaid Services (CMS), an arm of the U.S. Department of Health and Human Services (HHS)is facing as it implements a new Medicare EHR incentive program.

Members of Congress included funding for a formal EHR adoption incentive program in the Health Information Technology for Economic and Clinical Health (HITECH) Act provisions of the American Recovery and Reinvestment Act of 2009.

The EHR incentive program is supposed to encourage doctors and hospitals that treat Medicare patients to shift to EHR systems by paying bonuses to providers that show they are moving toward "meaningful use" of the systems.

CMS has estimated it will pay a total of $6.6 billion in EHR use bonuses by 2016.

Program backers argue that the incentives could help commercial health insurers as well as government plans, because most of the providers that treat Medicare patients also treat commercial plan patients.

Today, CMS is basing the EHR incentive payments entirely on self-reported use of certified EHR technology, HHS OIG officials said in their report.

The lack of strong prepayment safeguards and programs for verifying the reports "leave the program vulnerable to paying incentives to professionals and hospitals that do not fully meet the meaningful use requirements," officials said.

CMS officials said more rigorous testing requirements took effect in October.

"We will work with stakeholders this fall on test procedures that will be more comprehensive and will continue to migrate away from the exclusive use of vendor-supplied test data," CMS officials said.

See also:

GOP lawmakers question health record system incentives

On the third hand: fun with EHRs

Electronic Health Records: 16% of Hospitals, 9% of Doctors Get Medicare Incentive Pay

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Nichole Morford

Nichole Morford
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