GAO: CMS needs to fix EHR, e-prescribing reporting inconsistencies

Providers confused about incentive payment requirements of two Centers for Medicare and Medicaid Services (CMS)-administered programs--for electronic health records and for electronic prescribing--may get some clarity following recommendations from the Government Accountability Office (GAO).

In its analysis (required under the 2008 Medicare Improvements for Patients and Providers Act), GAO found similarities--and differences--in the technology and reporting requirements for both programs.

For instance, the EHR program provides incentives for adoption of the technology from 2011 to 2016 and introduces penalties beginning in 2015. However, the e-prescribing program provides incentives from 2009 to 2013 and calls for penalties from 2012 to 2014, when the program ends.

Also, the EHR program requires providers to adopt and use certified EHR systems meeting criteria from the Department of Health and Human Services--which include e-prescribing-related capabilities. However, the e-prescribing program does not have a certification requirement. This means that providers have no assurance that the systems they invest in will meet the e-prescribing program's requirements, GAO said.

Among its recommendations, GAO called for CMS to identify factors that can help or hinder implementation of the e-prescribing program--while assisting the ongoing implementation of the EHR program. CMS could include consideration of these factors in the integration plan that the agency is required to develop by Jan. 1, 2012, GAO said.

CMS also could develop a risk-based strategy to audit a sample of providers who received incentive payments from the e-prescribing program to help ensure they are meeting program requirements. This strategy could focus on providers who received larger incentive payments, GAO said.

For more details:
- see the GAO report

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