Billions of Unverified Medicare Spending Revealed in Audit

Both doctors and hospitals have been paid billions of dollars by Medicare to make the transition from paper to electronic health records without verifying that the new systems meet required quality standards, as reported by a federal audit recently released.

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Totaling $4 billion, the funds have been distributed since 2011 under an incentive program aimed at encouraging various types of medical providers to computerize their record-keeping systems.

The inspector general of the Department of Health and Human Services revealed a number of ways that the program is vulnerable to fraud in the report, and recommended that the Obama administration introduce stronger safeguards.

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Adopted by Congress as part of the 2009 economic stimulus package, the program is expected to distribute a total of $6.6 billion before it expires in 2016. Doctors can receive grants of up to $44,000; hospitals can get about $2 million.

To qualify, providers must “meaningfully use” the technology to improve health care in accordance with a detailed set of criteria — utilizing it to update immunization registries, for instance, or to issue prescriptions electronically.

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The inspector general found that Medicare officials are not requiring providers to prove that they are employing such meaningful use.

Officials at the Centers for Medicare and Medicaid Services countered that performing such reviews before compensating providers would unduly delay the payments.

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