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Medicare Meaningful Use Audit

By Tien Ngo, Meaningful Use Expert and Project Manager, e2o Health

Recently our HIT Consulting company, Meaningful Use Experts, has had two clients who received letters for meaningful use audits, one for Medi-Cal and one for Medicare. We are providing services to create the necessary documentation they will need for their audits. This article contains information on why a practice is selected for an audit, who the audit is with and what documentation is required at the time of the audit.

Why Me?

Medicare Audits are conducted by Figliozzi & Co, a law firm.  There are many factors that contribute to their audit selections such as the method each provider used to submit their attestation; their incentive program switched from Medicare to Medi-Cal; failure to provide adequate documents on a previous audit; or they were randomly selected. The reason might be different for each provider, so you will hear different stories from different doctors.   

If I am Selected for an Audit, What do I Need to Have?

If you are selected for an audit, you will receive an email and Audit Engagement letter from Figliozzi & Co.  Like any audit, you will have to provide documentation to support what you attested for the program year specified in the audit letter.  Below are some of the documents that Figliozzi & Co require:

1. The licensing agreements, invoices, and a letter from your vendor stating the Product Name, Vendor Name, and the Version number that you used during the attestation period.

2. You need to report on how many locations you had at that time.  If you only use CEHRT at one location, then you have to provide documentation to support that you chart at least 50% of your encounters in your EHR.  However, you don’t have to provide any documentation if you utilize CERHT for all of your locations during that time frame.  

3.  If you maintain medical records outside of your CEHRT, then you have to provide supporting documents that you chart at least 80% of your unique patients that you saw during the reporting period in your EHR.  (Note that this is not 80% of all your patients.)

3. Provide the meaningful use report for Core and Menu measures generated from your EHR and make sure you use the same reporting periods for which you attested.  

4. You will have to have done a security risk assessment for the year that you are attesting. This is a core requirement of Meaningful Use.

5. Provide supporting documentations for Patient List, Immunization Registry, or Syndromic Surveillance submission if you chose any one of those measures for attestation.  If the registries were not ready at the time of the attestation, then you need to obtain a letter from the registries saying that the registries were not ready.

After you have all the documentation, you can email or mail it to the auditor.  Please note that you will have to keep all the documentation for seven years.  

Meaningful Use Experts, a division of e2o Health, provides audit assistance. Please visit our website for more information on our services. or call us at (800) 409-0096








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