House committee wants answers from CMS, OIG on MU payments

The indictment of a former hospital chief financial officer for false Meaningful Use attestation has prompted a Congressional committee to probe deeper into how the Centers for Medicare & Medicaid Services screens providers before doling out incentive dollars.

In letters sent last week to CMS Administrator Marilyn Tavenner and U.S. Department of Health & Human Services Inspector General Daniel Levinson, the House Committee on Energy and Commerce, citing the indictment, requested answers to a number of questions about the adequacy of CMS' screening of providers and others receiving Medicare payments and OIG's oversight of CMS' screening activities.

The letter to Tavenner--signed by committee chair Fred Upton (R-Mich.) (pictured), vice chair Michael Burgess, M.D. (R-Texas) and chair emeritus Joe Barton (R-TX)--asks about the status of CMS' efforts to use predictive modeling; how the zone program integrity contractors are doing; if and how CMS is using other federal data bases to screen providers, such as the exclusion, debarment and dead provider lists; if CMS is coordinating with the Food and Drug Administration;, how CMS assures that it is alerted to "credible allegations of fraud" which could trigger a halt on paying claims; and how many Medicare revocations the agency has made in the last 10 years.

The questions posed to Levinson focus on what recommendations OIG has made to CMS relating to screening of providers or fund recipients; what actions OIG is taking to examine how CMS can improve screening; and what other data bases CMS could use to screen.

The letters request that responses be provided in a briefing on Wednesday, March 12. 

This Congressional salvo is the latest in a line of government inquiries into Meaningful Use and other payments to providers. Both OIG and the Government Accountability Office have expressed concern about EHR use, whether Meaningful Use payments were deserved, and whether CMS was adequately auditing the program.     

To learn more:
- read the letter to CMS (.pdf)
- here's the letter to OIG