Improper Medicare Payments for Meaningful Use, Telehealth?

Have the Centers for Medicare and Medicaid Services (CMS) been making improper payments to hospitals for the meaningful use of electronic health records (EHRs) and for telehealth services? That’s the question that the Office of the Inspector General (OIG) at the Department of Health and Human Services (HHS) will be considering. As Healthcare IT News first reported, CMS may have wrongfully paid out more than $729 million between 2011 and 2016. “These overpayments resulted from inaccuracies in the hospitals’ calculations of total incentive payments,” OIG officials said in a statement. “We will review the hospitals’ incentive payment calculations to identify potential overpayments that the hospitals would have received as a result of the inaccuracies.”

Incentive payments for the meaningful use of EHRs were first authorized by Congress in 2009 as a way to encourage hospitals and health care organizations to adopt EHRs and integrate them into their practices. For its part, the Government Accountability Office (GAO) asserts that improper payments put the entire program at risk. Another red flag: telehealth payments via Medicare Part B may not have been accurately calculated, either. As Healthcare IT News notes, CMS may have made payments for services rendered at ineligible originating sites (currently, only health care provider offices are eligible sites), which officials have also promised to investigate. As OIG explained, “We will review Medicare claims paid for telehealth services provided at distant sites that do not have corresponding claims from originating sites to determine whether those services met Medicare requirements.”

Over on Capitol Hill, some lawmakers are urging CMS to go further, and to take aggressive steps to actually recover the improper payments. In a letter to CMS Administrator Seema Verma, Sen. Orrin Hatch (R-UT) and Sen. Chuck Grassley (R-IA) raised concerns about the agency’s efforts thus far. “Given the estimated $729,424,395 in inappropriate incentive payments, why has CMS not made greater attempts to recover these funds?” the two wrote, also encouraging the agency to improve its auditing practices to prevent future payment errors. “If CMS is capable of recovering taxpayer money that should have not have been spent, the agency should take all reasonable steps to do so.”

Click here to read the article on potential improper payments from Healthcare IT News.

Click here to read the article on lawmakers encouraging CMS to recover the payments from Healthcare IT News

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