Massachusetts Medicaid Incorrectly Paid 19 Hospitals for EHR Incentive Payments

The Massachusetts Office of Medicaid and Office of Health and Human Services incorrectly paid 19 hospitals for the electronic health record (EHR) incentive program.

The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) reports that the Massachusetts state agency overpaid 13 hospitals by $2.7 million and underpaid six hospital by $564,000. They overpaid by a total of $2.1 million, reports the HHS OIG.

Furthermore, because these incentive payments are distributed over the course of three years, HHS OIG says that payments subsequent to the calendar year 2012 will be incorrect. The adjustments total $1.7 million. 

For the report, HHS OIG reviewed 25 hospitals. HHS OIG is recommending that Mass Medicaid refund the federal government program $2.1 million in net overpayments and adjust the 19 hospitals remaining incentive payments to account for those inaccurate calculations. HHS OIG also says Mass Medicaid should review the calculations for the hospitals not included in the 25 reviewed to determine whether payment adjustments are needed,

It also says the state agency should modify the hospital calculation worksheet to state that inpatient nonacute-care services should be excluded from the incentive payment calculation. Since the state agency did not report two hospital incentive payments to CMS's National Level Repository, HHS OIG also says Mass Medicaid should work with the Centers for Medicare and Medicaid Services (CMS) to ensure that this happens.