CMS has released guidance about the appeals process for health care providers who have failed to receive meaningful use incentive payments or are seeking to challenge their payout amount, Modern Healthcare reports.
Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health record systems can qualify for Medicaid and Medicare incentive payments.
Hospitals and health care providers who can seek appeals include:
- Those deemed ineligible to participate in the incentive program;
- Those denied status as a meaningful user; and
- Those who believe their incentive payments were calculated incorrectly.
Providers Resources -- a CMS contractor -- will work with the agency's Office of Clinical Standards and Quality to offer customer service and technical assistance to health care providers seeking appeals.
Timeline for Appeals Process
For hospitals, the deadline to appeal an eligibility determination has been extended from Dec. 31, 2011, to Jan. 30, 2012 (Conn, Modern Healthcare, 1/24). Other deadlines include:
- Health care professionals seeking to appeal their eligibility determination for payment year 2011 must file their appeal by March 30, 2012;
- Hospitals and eligible professionals seeking to appeal their status as a meaningful user must submit their appeal within 30 days after receiving a letter detailing the results of a meaningful use audit; and
- Hospitals and eligible professionals seeking to appeal their incentive payment calculation must file their appeal within 60 days after the incentive payment was issued (CMS guidance, 1/12).
Decisions on the appeals will be posted to a CMS website beginning in February (Modern Healthcare, 1/24).