Inspector General Finding May Delay EHR Incentive Payments

The U.S. government has spent billions subsidizing healthcare providers’ migration to electronic health records (EHR). Now the Office of the Inspector General for the U.S. Department of Health and Human Services wants to insert more red tape into the process and has asked that “high-risk” providers submit additional proof they actually did the work.

According to the Inspector General, the government has failed to verify that providers who have applied for federal incentives to convert from paper to electronic records actually completed the work. The Centers for Medicare and Medicaid Services, which oversees the program, “has not implemented strong prepayment safeguards, and its ability to safeguard incentive payments postpayment is also limited,” the Inspector General found.

It now wants CMS to hold up future payments for “selected professionals and hospitals prior to payment to verify the accuracy of their self-reported information.” It also asked CMS to publish guidelines of documentation that providers “should maintain to support their compliance.”

The Inspector General can only report and recommend, and in the case of requiring prepayment reviews, CMS declined to take action, stating it would impose a burden on providers and could delay incentive payments. CMS did agree to publish the requested guidelines.

The Inspector General’s office is holding firm to its demand of pre-payment reviews, so providers in coming months may find more red tape in their future as they migrate to EHR.

Some $4 billion has already been distributed since the beginning of the incentive program in 2011, and more than $2 billion has yet to be distributed for the program, which runs through 2016.