11/09/2015    Michael L. Brody, DPM

Meaningful Use Audit

The Meaningful Use audit process has been in
place for many years. Over the years, there have
been a number of different types of audits. The
most common Meaningful Use audit is a single year
‘desk audit’ that has been conducted by Figliozzi
and Company.

The audits by Figliozzi are for proof that you
have met each and every measure of Meaningful Use
for a single attestation period (Usually 1 year
but sometimes 90 days or a calendar quarter. In
addition, there have been limited audits
conducted directly by CMS that have only looked
at proof that you had access to certified EHR
technology, and there have been full audits by
the OIG (Office of Inspector General) that look
at each and every year that a provider has
attested for.

When an audit is passed you receive a letter
informing you that you have passed the audit.
The letters from Figliozzi contain a disclaimer
statement that informs you just because you have
passed this audit does not mean that you will not
be audited again. In addition, when a practice
fails an audit they are automatically audited for
any other years that they attested for.

Almost 25% of all practices that are audited for
Meaningful Use fail the audit. The most common
reason for audit failure is failure to have
performed a proper Security Risk Analysis. As a
result there is a lot of money on the table
available for CMS to recoup. With this finding,
the rate of audits has increased significantly
recently.

In order to pass an audit you need to have
documentation available to support all of the
information in your Meaningful Use attestation.
Now is a good time to gather all of that
information. Among the problems that have been
encountered during an audit are:

· Your vendor has gone out of business and you
are no longer able to produce a report with the
numerators and denominators that you used to
attest with.
· Your vendor has gone out of business and you
can not get a letter from them that proves you
had access to certified technology
· Your vendor has updated your software and the
report you generate today does not match the
numbers you used when you attested for Meaningful
Use
· A doctor was a member of your practice, has
left and you are being audited for that doctor
and can not get signed statements from that
doctor which are necessary for some of the
measures.

Meaningful Use payments are payments from CMS and
you can be audited for Meaningful Use for up to 7
years after you receive payment. It is important
that you retain all documentation related to each
and every Meaningful Use Attestation for at least
7 years so that you are able to respond to an
audit.

When you received your audit letter it contained
the name of your auditor and their extension. If
you have been audited, please feel free to call
the auditor and ask about the status of your
audit. Even better yet, if you are audited PLEASE
call your malpractice insurer. PICA has
Administrative Defense as one of the policy
benefits.

Under this benefit, PICA will put a team together
to represent you in the audit. That team often
includes me. This team ls lead by an attorney and
we have handled hundreds of Meaningful Use
audits. We are experienced in processing these
audits and are on a first name basis with many of
the auditors which can help to expedite the audit
process. In addition to representing many PICA
policy holders, we have represented individual
podiatrists who happen to not be PICA policy
holders.

Should an audit fail, there is a one time appeal
process. Unlike other Medicare audits, you do not
have the ability to eventually go to an
administrative judge. So especially if you fail
the audit is is imperative that you get help in
filing the appeal to optimize your chances during
the appeal process. We have filed numerous
appeals and have been successful in a number of
appeals.

The Administrative Defense portion of the PICA
policy covers you for representation for any type
of audit, Meaningful Use, Medicare, and many
other administrative actions including board
actions. I strongly recommend that each and every
reader investigate what benefits their current
policy has and if you are audited contact your
malpractice carrier immediately so that you have
a full team available to represent you should you
experience any type of audit.

If your insurance carrier does not provide this
vital benefit, please feel free to reach out to
me and I will see if I can assist you directly in
responding to your Meaningful Use audit.

Michael L. Brody, DPM, Commack, NY

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