General Surgery Coding Alert - 2015 Issue 45
Physician Notes: EHR Incentive Payments Are Valuable--But Not This Valuable
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Article Overview
This article covers two Medicare/Medicaid compliance topics of interest to providers and billing professionals: an OIG report on incorrect Medicaid electronic health record incentive payments in Texas, and CMS adjustments to Recovery Audit Contractor review limits and timelines. It is relevant for readers tracking audit activity, federal oversight, and payment integrity issues affecting hospitals and other healthcare organizations.
Why This Topic Matters
The piece highlights how payment calculation errors can lead to significant overpayments and future recoupment, while also noting policy changes that may alter audit pressure on providers. It helps compliance, revenue cycle, and coding stakeholders understand broad enforcement and oversight trends.
Article Sections
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EHR incentive payment overpayments in Texas
Discusses an OIG review of Medicaid electronic health record incentive payments and the resulting state-level overpayment and underpayment findings. It also notes the broader reimbursement impact identified in the report.
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CMS Recovery Audit Contractor policy changes
Summarizes CMS updates affecting Recovery Audit Contractor review limits, review timing, and provider-specific audit intensity. It also references related commentary on oversight and recoupment trends.
What You Will Learn
- How the article frames EHR incentive payment integrity issues in a state Medicaid program
- What general CMS changes are being made to Recovery Audit Contractor review activity
- Why the article is relevant to compliance and reimbursement oversight monitoring
- Which organizations and policy areas are central to the update
Who Should Read This
- Physicians
- Hospital compliance staff
- Health information management professionals
- Medical coders
- Revenue cycle professionals
- Billing managers
- Healthcare administrators
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