The Final Rule and Meaningful Use Audits
The long awaited Final Rule gave providers a clearer view for 2015 – 2017 and Stage 3 Meaningful Use (MU). Some of the most fascinating details are found in the nuances buried in the response to public comments. The careful reader is provided insight into the CMS position on the importance of a number of important issues including the MU requirement for a Security Risk Analysis.
The Final Rule also weighed in on the issue of the audit/appeal process. Public comments were received concerning the difficulty some providers were having with communication and notification due to email related issues. CMS says that is up to the provider to make sure things work on their side,
The Final Rule contained some text that I found not entirely rooted in reality based on my personal experience with quite a few audits and appeals involving both eligible professionals and hospitals.
I have documented numerous instances of a flawed appeals process. This includes “lost appeal submissions”, “inconsistent rulings”, and the presence of “two sets of rules”. Details are available for your review in these posts: A Tale of Meaningful Use Injustice and CMS Audit Appeals Process Leaves Providers Desperate for Clarity. I have contacted numerous CMS officials trying to schedule a call to provide feedback on the effect these practices are having on providers as they try to comply with the MU program. I have even offered to travel to Washington for a meeting. I have been turned down in both cases.
Along these same lines of improving the MU incentive process, the Office of Inspector General (OIG) has a stated mission “to protect the integrity of Department of Health & Human Services (HHS) programs as well as the health and welfare of program beneficiaries.” The OIG Work Plan for 2015 included the performance of provider MU audits.
Earlier this year one of my clients was the recipient of an OIG MU fact finding audit. The purpose of the oversight audit was to determine whether the incentive payment program is in “accordance with Federal and State requirements”. I contacted both OIG’s Inspector General for Audit Services as well as the Inspector responsible for my client’s audit and offered to provide information relevant to the process. Haven’t heard from either of those folks either. Reminds me of the classic Pink Floyd lyric. “Is there anybody out there?”