Meaningful Use Incentives: The Big Giveback

Hospital System Returns $31 Million in EHR Incentives

By Jim Tate, EMR Advocate
Meaningful Use Audit Expert
Twitter: @JimTate, eMail:

Take away, give away, and maybe even throw away. However you view the merit of incentivizing the adoption of EHRs those CMS meaningful use incentives have been bouncing all over the landscape for three years. There is no doubt that a river of cash has successfully fueled the adoption of electronic healthcare technology. As of September 2013 over 16 billion dollars has flowed into the coffers of healthcare providers. That is a lot of moola, scratch, dough, wampum, loot, cabbage or whatever else you call legal tender. I guess it all depends on your perspective as to whether it is money well spent. Since 2003 the war in Iraq has cost over 815 billion dollars and every year over 60 billion dollars is spent on soft drinks in the good old USA. Now I like Fanta as much as the next fellow and Mountain Dew is pretty important in my neighborhood but I’m thinking we are still getting a pretty good bang for the bucks being paid to providers for meaningful use.

Some of those glorious incentives have been returned, willingly or not. The audit process is now fully in swing and more than a few bundles of the loot have been returned, or “recouped” as we like to say.  Pre-payments, post-payments, every which way payments have been making the round trip from the incentive treasure chest to the healthcare providers and back again. Those ever increasing audits are starting to have an effect.

Claw backs, take backs, and now we even have givebacks. Give backs? What the heck is that? I have to admit I haven’t heard of any give backs, until last week. The bottom line is that Health Management Associates has returned $31 Million of Medicare and Medicaid EHR incentive payments.  $31 million? Now that’s a lot of Fanta. HMA states “In October 2013, based on the results of an internal review, the Company determined that it had made an error in applying the requirements for certifying its EHR technology under these programs and, as a result, that 11 of the hospitals it had enrolled in the HCIT programs did not meet the “meaningful use” criteria necessary to qualify for HCIT payments.” I would love to know the back story behind the press release. What was the “error” that was made? Even more fascinating would be how the error came to light and who had to break the news to management? I would guess a few careers might have been affected by the fallout and maybe more than a little finger pointing is going on. We may never know the details but I imagine a few hospital systems are now reviewing their own incentive strategy, assumptions, and history. Hope they don’t find anything that would lead them to making a difficult decision.

Holidays are just around the corner and I suspect Santa is doing his own audit to see who has been naughty or nice. From what we have seen in the past few weeks more than a few stockings might contain a lump of coal.

Jim Tate is known as the most experienced authority on the CMS Meaningful Use (MU) audit and appeal process. His unique combination of skills has brought successful outcomes to hospitals at risk of having their CMS EHR incentives recouped. He led the first appeal challenge in the nation for a client hospital that had received a negative audit determination. That appeal was decided in favor of the hospital. He has also been successful in leading the effort to reverse a failed appeal, even after the hospital had received notification of the failure with the statement, “This decision is final and not subject to further appeal”. That “final” decision was reversed in less than a week. If you are a hospital with questions or concerns about the meaningful use audit process, contact him at: