It’s T minus 11 months until the Affordable Care Act (ACA) fully kicks in. So, let’s visit another timely issue: meaningful use. A year or two ago, those phrases were music to the average doctor’s ears...“What’s that you said? All I have to do is upgrade my EHR software, and attest that I’m doing certain things in my practice on a continuous basis for 90 days in my first year and then the whole year for each of the remaining, and I can get up to 75% of my Medicare billings or $44,000 per doctor? Holy crap, where do I sign up?” February 28, 2013, is the last day for Medicare-eligible professionals (EPs) to register and attest to receive an incentive payment for calendar year (CY) 2012.

And now the government is coming to check on you to see that its money was well spent. Yes, folks, the days of “easy money” are over.

Remember, the purpose of meaningful use is to demonstrate that you are using your EHR to positively affect the care and outcomes of your patients. Now the Centers for Medicare & Medicaid Services (CMS) will make you demonstrate that you are actually doing what you said you were doing, or else. Yep, the attestation audits have begun. If you’re not doing what you claimed you were doing to meet the standards of Phase I meaningful use requirements, that money is now in jeopardy.

If you’ve forgotten what “attestation” is, here’s a reminder: Attestation means you have met the thresholds and all of the requirements of the Medicare EHR Incentive Program. The process of attestation happened through an Internet-based CMS system that allowed you to enter information on all of the following:

  • 15 core objectives
  • Five out of 10 menu objectives
  • Three core (or three alternate core) clinical quality measures
  • Three out of 38 additional clinical quality measures

In order to get this money, one of the things that you had to do was to certify that you had met the standards and that your office management system and EHR system were up to the task of doing so. The software manufacturers had to spend significant dollars in development costs to ensure that their systems could get certified for meaningful use, and you had to make sure that you did your part in using that extended functionality on a continuous basis.

Well, the government is now finding out that many practitioners said they were meeting the standards but actually weren’t, and it may start asking for its money back.

So, what can you do? First, check out this website that CMS has created for FAQs regarding its guidelines for documentation and proof:

If you’re just now attesting, please make sure that you document everything and retain it.

If you’ve already attested, make sure that you’re doing everything (and I really mean everything) that you said you were doing to meet the requirements. If you aren’t doing everything, then document a plan to solve the problem and document your progress on fixing it. You need to be bulletproof.

For these audits, it may not be a question of if it will happen, but a question of when. So, should you get that letter for a meaningful use attestation, be sure your house is in order and you can survive to work another day.

1. Centers for Medicare & Medicaid Services website. Medicare EHR Incentive Program, Physician Quality Reporting System and e-Prescribing Comparison. March 2011. Available at: Accessed January 31, 2013.