CHIME: OIG’s EHR Incentive Recommendation Would Delay Payment Process

November 30, 2012
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Like the Centers for Medicare & Medicaid Services (CMS), the College of Healthcare Information Management Executives (CHIME) both agreed and disagreed with the Office of the Inspector General (OIG) in its sharp critiques of the Medicare EHR incentive program in a recent report.

In a response to the report, Sharon Canner, senior director of advocacy for CHIME, said the organization supports the OIG recommendation that CMS develop and disseminate guidance detailing the types of documentation that eligible hospitals and eligible professionals need on hand to comply with audits. She said, CHIME even wrote a in a letter to the Secretary of the U.S. Department of Health & Human Services asking for this in the summer of 2011. However, they weren’t keen on all of OIG’s recommendations.

“We do not believe it necessary that CMS collect documentation beyond attestation form hospitals and eligible professionals prior to sending payments. We agree with CMS’s stated response to OIG that such an action would impose a significant delay on the payment process, causing an unnecessary and detrimental situation for providers,” Canner said.

In its response to the OIG report, CMS said “prepayment audits would increase the burden on practitioners and hospitals and could delay incentive payments.”  However, CMS did agree with some of the other OIG recommendations, such as developing guidance on documentation to comply with audits.

John Halamka, M.D., CIO of Beth Israel Deaconess Medical Center (BIDMC), said the CMS/ONC response to the OIG critiques was right on.  

“I give ONC a lot of credit for the efforts of the last few years,” said Halamka. They’ve tried to implement a brand new program with a lot of unknowns. How can one reduce fraud and abuse in a program of this complexity and novelty? I think ONC recommendations for doing enhancements to the certification of systems so they automatically report adherence or non-adherence to certain meaningful use core and menu-set measurements. That seems like a reasonable path forward.”

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