Providers 'struggling' to document Meaningful Use attestation

Preliminary results from the Centers for Medicare & Medicaid Services' Meaningful Use audits indicate that providers are having a lot of trouble substantiating what they've attested to, according to Robert Anthony (pictured), deputy director of the Health IT Initiatives Group at CMS' Office of e-Health Standards and Services.

"Most of the issues center around documentation, the things to keep, especially for the yes/no measures," he tells FierceEMR in an exclusive interview.

For instance, some electronic health record systems don't provide an audit log to let users record when they began tracking a measure for a period of time, so it's harder to show when the provider "turned on" that functionality. In those cases, providers should use a dated screen shot to substantiate the time period, Anthony suggests.

Also, some EHR systems will generate a report based on a snapshot in time, but other systems have "rolling systems" that can cause the numbers in the EHR to change after the provider has attested. In those cases, providers should keep a copy of their original report to substantiate which numbers were used for attestation. "Know what kind of system you have," Anthony recommends. 

CMS expects to conduct both random and targeted post- and pre-payment attestation audits on at least 5 percent of Meaningful Use attesters. The audits are required by the Health Information Technology for Economic and Clinical Health Act, which created the Meaningful Use Incentive program. CMS has released new tools to help providers substantiate their documentation and prepare for audits.

Some providers have received adverse finding letters because they either didn't not meet the Meaningful Use objectives, or because they couldn't substantiate that they had done so, according to Anthony.  

"We want to make sure that the right people are getting paid," he says.

The good news: attesters are performing at a "very high level," Anthony says. "It's a trend across all providers. They're scoring 90 when the goal was 50," he says.

To learn more:
- check out CMS' new attestation documentation guidance (.pdf)
- here's CMS' new EHR attestation audit fact sheet (.pdf)

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