CMS may find other improper EHR claims after HMA's errors

Hospitals nationally will be taking a closer look at their eligibility for receiving federal incentive payments for electronic records following Health Management Associates' announcement last week that 11 of its hospitals had improperly claimed $31 million because they had not met the government's meaningful-use requirements.

The hospital chain blamed the problem on “a control deficiency related to the administration and oversight of the company's EHR enrollment process.” HMA has retained the Baltimore-based law firm Ober Kaler to review its procedures for certifying achievement of the standards. During the past three years, hospitals have had to meet 14 core standards as well as report 15 quality measures and five “menu” objectives to the CMS to qualify for the payments.

Givebacks under the incentive program have been rare so far. But Robert Tennant, senior policy adviser for the Medical Group Management Association, said that some medical groups had to return the money after finding problems with a vendor and that “their numbers were not in order.”

The CMS may uncover more problems in its ongoing series of audits, which started last fall. The agency plans to audit 5% to 10% of recipients and applications.

“I could see a prudent compliance officer saying, 'We'd better get in and take a look at EHR payments,' ” said Lynn Sessions, a Houston-based lawyer with BakerHostetler specializing in compliance, privacy and security issues. Sessions said compliance officers may have stopped asking questions as CIOs pushed to get systems installed and the organization geared up to qualify for payments. “Now that we have audits, we've started hearing from clients again” about the IT program, she said.

Follow Joseph Conn on Twitter: @MHJConn