CMS says it will be going after more than $700 million that the OIG discovered in improper payments under the Meaningful Use program that made incentive payments for implementation of electronic health records. The OIG audit found that approximately 12% of the incentive payments were improperly paid because providers failed to maintain documentation to support their “self-attestations” submitted for payment.
A smaller $2.3 million segment of the improper payments came from providers switching between the Medicaid and Medicare meaningful use programs. The OIG stated that CMS failed to verify that the submissions were in the correct payment years, resulting in double payments.
The OIG determination of overpayment was based on a sampling of providers which found $291,000 in payments to sampled providers who failed to meet the Meaningful Use requirements. The $700 million figure is a statistical projection from the sample findings. Interestingly, the OIG is recommending that CMS return the $291,000 to the providers who failed to meet the payment requirements, but that they pursue the remaining $700 million.
Details were not released by CMS on how the recovery effort will be pursued.