The Centers for Medicare and Medicaid Services routinely reminds physicians about the Physician Quality Reporting System and Electronic Prescribing (eRx) financial incentive programs and encourages participation. Now, however, CMS is seeking ways to get some of that money back.
In a notice available here and being published on March 17, CMS contends the programs have data integrity issues such as rejected and improper payments. The agency plans to annually survey group practices, registries and data submission vendors, a total of 400 each year, with follow-up interviews with a small number of respondents.
This four-year project will evaluate incentive payment information for accuracy and identify improper payments, with the goal of recovering these payments, CMS explains in the notice. Additionally, based on the projects results, recommendations will be made so that we can avoid future integrity issues. CMS does not use the word audit in the notice.
CMS will analyze data submission, processing and reporting procedures for potential errors, inconsistencies and gaps that are related to data handling, program requirements and clinical quality measure specification of PQRS and eRx programs, according to the notice.
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