Eagle Consulting, Inc. has worked with healthcare providers who have failed meaningful use audits in the last two years. In each of these cases, the providers contacted us after the auditors found that they had not completed a legitimate risk analysis as required by Core Objective #15 (#14 in Stage 2). The maximum penalty that we are aware of has been the return of incentive monies provided. Now, as we warned about years ago, a health provider in Texas has been charged with Medicare fraud.
A former Texas hospital CFO, White, was indicted by a federal grand jury in January and is facing charges of making false statements to the Centers for Medicare and Medicaid Services (CMS) and aggravated identity theft. According to the indictment, “if convicted, White faces up to five years in federal prison for making a false statement and up to two years in federal prison for aggravated identify theft.” 
The indictment states that the accused falsely attested to CMS that his employer, the Shelby Regional Medical Center, had met the meaningful use requirements for the 2012 fiscal year. However, the hospital “relied on paper records throughout the year and only minimally used electronic health records,” the indictment alleges. He is also being charged with identify theft for attesting using another person’s name and information without that individual’s consent or authorization. While the individual charged is innocent until proven guilty, the allegations, if true, go beyond misunderstanding details of a complicated program. As a result of this false attestation, CMS paid Shelby Regional $785,655.00. And in total, hospitals operated by Shelby Regional were paid $16,794,662.66 by the Medicaid and Medicare EHR incentive programs for the fiscal years 2011 and 2012, representing a substantial chunk of operating cash to return.
“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 of the U.S. Department of Health and Human Services Office of Inspector General’s (OIG) Dallas Regional Office. Meaningful use payments represent significant sums of money, and healthcare providers should know that the government is serious about the rules. “The Office of Inspector General is committed to protecting the millions of taxpayer dollars used to pay providers to adopt Electronic Health Record systems,” warns Fields.
So, if there is something that you don’t understand, we advise that you seek professional help.
Editor’s Note: Subsequent to the publication of this article, CMS has renamed the “Meaningful Use” programs and MIPS “Advancing Care Information” category to “Promoting Interoperability”.
