Arkansas has made incorrect Medicaid electronic health record incentive payments to hospitals totaling $1.2 million over an 18-month period, according to a new report from the U.S. Department of Health and Human Services' Office of Inspector General (OIG).
The report, released July 6, audited 20 hospitals that received the highest Medicaid incentive payments by the Arkansas Department of Human Services from November 2011 to June 2013, determining that incorrect payments were made to 14 of those facilities. However, because OIG could only determine correct payments necessary for 13 of the 14 hospitals, it set aside its entire $1.5 million in incentives in order for the state and the hospital to sort out the mess. Eight of the facilities were overpaid by the state, while five were underpaid, resulting in a net overpayment of $79,428.
The errors occurred because the state did not follow federal calculation requirements, personnel did not review supporting documentation and, in one case, used the incorrect cost reporting period. OIG recommended, among other things, that the state refund the $79,428 to the federal government, adjust the incorrect payments found in the audit, review its calculations to ensure that this is not occurring with other providers and provide guidance to hospitals regarding what should be included and excluded in their Meaningful Use calculations.
Overall Arkansas dispersed $54 million in Medicaid EHR incentive payments during the audit period.
"The Government Accountability Office has identified improper incentive payments as the primary risk to the EHR incentive programs," the report states. "These programs may be at greater risk of improper payments than other programs because they are new and have complex requirements. Other [HHS OIG] reports describe the obstacles that the Centers for Medicare & Medicaid Services and states face overseeing the Medicare and Medicaid EHR incentive programs. The obstacles leave the programs vulnerable to paying incentive payments to providers that do not fully meet requirements."
This is the fourth state agency audited by OIG. In 2014, the OIG found that Louisiana and Massachusetts made incorrect Medicaid EHR incentive payments, while Florida passed muster.
The Meaningful Use incentive program is a priority issue for the OIG. It has also begun to audit individual providers to determine if they have met the Meaningful Use requirements and earned an incentive payment.
To learn more:
- here's the report (.pdf)