The Oklahoma Health Care Authority (OHCA) has made incorrect Medicaid electronic health record incentive payments to healthcare professionals totaling $888,250, as well as several other mistakes, according to a new report from the Department of Health and Human Services' Office of Inspector General (OIG).
The audit, released Sept. 23, reconciled professional incentive payments reported on the state agency's CMS-64 report for 2011 and 2012, with supporting documentation and the National Level Registry, the vehicle by which providers attest to Meaningful Use. The OIG also performed a complete eligibility review on 28 professionals and analyzed claims data to determine whether they were hospital-based. Oklahoma is one of the first states to make Medicaid Meaningful Use incentive payments.
The OIG found that $888,250 was paid to 47 hospital-based professionals after the agency misinterpreted the time frame for determining hospital-based status. OHCA also claimed $127,500 more than it paid because it mistakenly included six duplicate payments in its Report to CMS. The data additionally did not include a $21,250 payment because of data transmission problems to the repository and lack of reconciliation procedures.
The OIG recommended, among other things, that the state refund the federal government the $888,250 in overpayments as well as the $127,500 in over reported payments, and to ensure that the $21,250 is successfully transmitted.
The Government Accountability Office has identified improper incentive payments as the primary risk to the Meaningful Use program, in part because its requirements are complex. The Medicaid Meaningful Use program is estimated to pay about $12.4 billion in incentives.
The OIG audit is one of a series of Meaningful Use audits being conducted. This is the seventh state agency audited by the OIG, which has previously expressed concern about the program's vulnerabilities. In 2014, the OIG found that while Florida made payments correctly, Louisiana and Massachusetts made incorrect Medicaid EHR incentive payments. So far in 2015, the OIG found that Arkansas and Texas made incorrect payments, while the District of Columbia made payments correctly.
To learn more:
- here's the report (.pdf)