State Hires Medicaid Meaningful Use Auditor

The Texas Health & Human Services Commission hired Davila, Buschhorn & Associates to audit payments to Texas physicians under the Medicaid electronic health record (EHR) incentive program. A separate auditing firm is examining Medicare EHR incentive payments.

Physicians who fail the audit may have to repay the money they received. They do have the right to appeal. Details about the audit process and appeals are available here.

The Medicaid EHR auditor may ask you for information on patient volume that determines your eligibility to participate in the incentive program, as well as compliance in meeting the meaningful use measures. Pediatricians must have at least 20 percent of their patients on Medicaid; all other specialties must have at least 30 percent to qualify for the program.

To prepare for a possible audit, document how you calculate your patient volume and keep screenshots or reports. Also, document meaningful use calculations and maintain all reports used for attestation.

For more information on the audits, call TMA's Health Information Technology Department at (800) 880-5750 or email HIT.

TMA recognizes the complexities of the EHR incentive program and recommends physicians struggling with the program to consider contracting with one of the Texas regional extension centers (RECs). Details about the REC program and which one serves your area are available in TMA's Texas REC Resource Center

Action, Oct. 1, 2013


Last Updated On

April 19, 2018

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