Obama Program Made $729 Million in Erroneous Payments to Doctors

Stimulus program to incentivize using electronic health records 'vulnerable to abuse'

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June 12, 2017

An Obama administration program to encourage the use of electronic health records made over $729 million in erroneous payments, according to a new audit.

The Centers for Medicare and Medicaid Services also paid dead doctors for enrolling in its program, the audit, released by the agency's inspector general Monday, revealed.

"From May 2011 through June 2014, the Centers for Medicare and Medicaid Services paid an estimated $729 million in Medicare electronic health record incentive payments to eligible professionals who did not comply with Federal requirements," the inspector general said. "In addition, it paid $2.3 million in inappropriate electronic health record incentive payments to eligible professionals who switched incentive programs."

The incentive programs were created under the American Recovery and Reinvestment Act, commonly known as the stimulus package, signed by former President Barack Obama in 2009.

Beginning in 2011, Medicare and Medicaid paid hospitals, as well as doctors, podiatrists, optometrists, and chiropractors up to $43,720 each for meeting several requirements that demonstrated their "meaningful use" of electronic health records. The programs spent $6 billion during the first three years.

The inspector general found the government has "conducted minimal" oversight over whether doctors met program requirements, leaving the program "vulnerable to abuse and misuse of Federal funds."

The inspector general said doctors who received $729 million were ineligible because they did not use certified electronic health record technology enough, or did not have documentation to back up their claims. Requirements for the program include providing patients with their health information online.

The government also overpaid doctors who were enrolled in incentive programs for both Medicare and Medicaid by more than $2.3 million. Doctors cannot receive payments from both programs during the same year.

In addition, the inspector general identified one deceased doctor who was paid $11,760, and two deceased doctors who are still active in the government's payment systems. Eleven dead doctors were deactivated from the program from than two months after they had died.

The Centers for Medicare and Medicaid Services agreed with most of the audit's findings, but only partially agreed that it needs to attempt to recover the $729 million in ineligible payments.

Patrick H. Conway, then-acting administrator for CMS, replied for the agency in February, saying, "CMS has implemented targeted risk-based audits to strengthen the program integrity of the EHR Incentive Program, and continues to perform these targeted risk-based audits in 2016 and 2017."

The inspector general said the agency should continue to try to recover the $729 million and that the agency's internal audits are not working to uncover abuse within the programs.

"After reviewing CMS's comments and having followup discussions with CMS officials, we maintain that the targeted risk-based audits are not capturing errors such as those identified in this report," the inspector general said.