A CMS spokesperson tells Part B News that the recent eClinicalWorks (ECW) settlement won't lead to blanket incentive payment takebacks or worse, as some providers had worried.
As detailed in a new Part B News story, on May 31 the Department of Justice announced the electronic health record (EHR) company settled fraud charges with a $155 million payment. DOJ had charged that ECW faked its way through its certification tests and its software did not come up to certified EHR technology standards required for users to demonstrate meaningful use and collect EHR incentive program payments. Note that ECW did not admit guilt in the settlement.
Experts were confident that providers who used ECW and claimed those payments in good faith would suffer neither payment takebacks nor enforcement issues, despite the alleged fraud. And the CMS statement confirms that.
"Providers that in good faith successfully attested using eCW software and received an incentive payment will not have to repay the incentive payment," the spokesman said. "CMS realizes that providers may rely on the software they use for accuracy of reporting and CMS does not plan to audit eCW providers based on the settlement under which eCW has agreed to repay approximately $125 million to the Medicare and Medicaid EHR incentive payment program."
The source pointed us to a brand new CMS FAQ, which seems to confirm that interpretation:
The questioner says he recently found "the method of calculation included in the software" he got from his EHR vendor was "flawed" -- which sounds a lot like the drug formulary issue at the heart of the government's accusation against ECW -- and wants to know, "If CMS audits me, will I be held responsible for the difference between what I reported and what the updated software calculates?"
"CMS does not plan to conduct an audit to find providers who relied on flawed software for their attestation information," CMS answers. "We realize that providers relied on the software they used for accuracy of reporting, and we believe that most providers who were improperly deemed meaningful users would have met the requirements of the EHR Incentive Programs using the updated certified EHR technology."
Update: CMS statement updated on June 13 to clarify that they were talking about "good faith" attestations and that they did not plan to audit users based on the settlement.