EHR Incentives and Meaningful Use for Anesthesia Billing

Anesthesiologists are eligible for the CMS EHR Meaningful Use (MU) Incentive Program (as long as more than 10 percent of services are in an outpatient or ambulatory surgery center setting). But, qualifying for the MU incentives requires use of a certified EHR, personal attestation to meaningful use of it, and expanding EHR use to meet Stage 2 and subsequent requirements. Because of these complexities, most anesthesia groups are taking advantage of the exemption granted to anesthesiologists. Those participating or considering it are strongly encouraged to understand the risks involved.


 

These risks appear to be increasing rapidly. The FBI recently announced an Indictment alleging false attestation of Meaningful Use (“MU”). The indictment alleges that the hospital “relied on paper records throughout the year and only minimally used electronic health records”. The FBI’s press release1 goes on to say, “To give the appearance that the hospital was actually using Certified Electronic Health Record Technology, the software vendor and hospital employees were directed to manually input data from paper records into the electronic health record (EHR) software.”

 

“As more and more federal dollars are made available to providers to adopt Electronic Health Record systems, our office is expecting to see more cases like this one,” said Special Agent in Charge Mike Fields.

 

In a related development, the OIG workplan2 for 2014 includes a focus on MU payments: “We will review Medicare incentive payment data from 2011 to identify providers that should not have received incentive payments (e.g., those not meeting selected meaningful use criteria).”

 

 This article is not legal advice and readers are encouraged to consult with their attorney on any matters related to this or similar topics. 

1 http://www.fbi.gov/dallas/press-releases/2014/former-hospital-cfo-charged-with-health-care-fraud

2 https://oig.hhs.gov/reports-and-publications/archives/workplan/2013/Work-Plan-2013.pdf