EHR Audit

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Please contact our office for additional information concerning the Mississippi Medicaid EHR Provider Incentive Program Audit Strategies, Appeals Process, and Re-coupment of EHR Incentive payments.

Currently, the MS Division of Medicaid reviews all Attestations submitted as part of a pre-payment verification requirement. 

We verify the following:

  • Medicaid Patient Volume
  • EHR Certification
  • Payment Calculations for Eligible Hospitals
  • Various EHR Meaningful Use reports (CPOE, Problem List, etc…)
  • Payee Group Affiliation
  • Active Medicaid Providers (NPI, Medicaid ID, TIN, etc…)

Additional information will be required if your EHR Attestation is chosen for a Post-Payment Audit.   The MS Division of Medicaid uses a combination of random-selection and a comprehensive Risk Analysis to determine providers that will be audited during a particular year.   EHR users that implement free or ‘no-cost’ software solutions will automatically be audited.  EHR users that receive only an initial incentive payment and not return to demonstrate Meaningful Use will be audited.   The Mississippi Division of Medicaid audits the EHR Provider Incentive Program.   There is a distinction between operational staff and audit staff.

All participants in the EHR Provider Incentive Program will at one time or another (over the course of the incentive program) will find themselves in a Post-Payment Audit.  Please retain all records in the event you are selected for a Post-Payment Audit.  You will need to fully support all the data that was entered in the MS SLR, including, but not limited to – Medicaid patient volume, All payers encounter information, EHR MU reporting data, Appropriate Certification of your EHR by the Office of the National Coordinator (ONC), EHR vendor contracts and ongoing vendor support letters, etc…..

Most audits conclude with a favorable finding and incentive payments are not taken back.  However, if a audit ends with an adverse finding, all related incentive payments will be taken back after the Appeals process has been followed.

All audits are reported to CMS, regardless of final outcome.

Please let us know if you have any questions.

 

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