Health IT: New Medicaid rules, a race for meaningful use, fraud prevention

Instructions for state Medicaid directors to distribute some of the funding for electronic medical records through their programs beginning next year have been circulated by the federal Centers for Medicare & Medicaid Services, American Medical News reports. "The incentive program stipulates that the federal government will pay the full cost of Medicaid bonuses to eligible physicians who adopt certified EMR technology in a way that meets the government's 'meaningful use' criteria. It also will pay 90% of states' eligible administrative expenses. Aspects of the latter have been a source of particular confusion for state agencies, which is why CMS chose to issue the additional guidance on Aug. 17, according to policy experts familiar with the incentive program." The federal government is also offering Medicare incentives to adopt health IT, but physicians may not cash in on both (Silva, 8/30).

AnnArbor.com: These incentives are "part of a push to get hospitals and physicians' offices across the health sector to invest in electronic health records to better streamline health care delivery and quality." About $27 billion will become available to [doctors and hospitals] who prove they are meaningful users of systems that meet the government's definition of a qualifying electronic health records system. After 2015, Medicare penalties will be imposed on those who aren't." That deadline has set some providers in a race against the clock (Reed, 8/28).

The Washington Post, on another government program at the intersection of technology and health care: Fraud prevention in North Carolina. "IBM has a yearlong contract to comb through six years of [the state's Medicaid] data -- the statute of limitations is six years -- to find questionable payments that the state can investigate and, if inaccurate, demand be repaid. The program is just one of many through which contractors are helping governments recoup lost assets and protect their money -- a need that has only become more pressing following the recession and tightening of state and local budgets." Because the state was too broke to hire IBM, they negotiated a deal in which the the firm would take a cut of what it helps recoup (Censer, 8/30).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.