Medicaid EHR payment errors identified

Posted on: 10/19/16

Eleven Oklahoma hospitals were incorrectly paid for Medicaid electronic health record (EHR) incentives, according to a recent audit by the Office of Inspector General (OIG) of the Department of Health and Human Services.

The OIG reviewed approximately $45 million in EHR incentive payments made to 25 Oklahoma hospitals for program years 2011 and 2012. These payments represent about 62 percent of the total Medicaid incentive payments made to Oklahoma hospitals for these years.  

The OIG found that the state overpaid seven hospitals a total of $1,082,128 and underpaid four hospitals a total of $401,760, for a net overpayment of $680,368.

The state’s errors included counting non-acute care patient days in the incentive calculation, and using data that was not supported by documentation.  

The 11 hospitals have been notified of the amounts overpaid or underpaid.

Myers and Stauffer, an accounting firm that also audits Oklahoma’s Disproportionate Share Hospital program, has been hired by the state to perform similar audits of Medicaid EHR payments for more recent program years. These audits include both hospital and physician incentive payments. It has not yet been determined if Myers and Stauffer will audit the 2011 and 2012 incentive payments not selected for audit by the OIG.

A copy of the OIG report is available here.  (Rick Snyder)