Ohio Made Incorrect Medicaid Electronic Health Record Incentive Payments

From January 1, 2011, through December 31, 2012, the Ohio Department of Medicaid (State agency) made incorrect Medicaid electronic health record (EHR) incentive payments totaling $526,000 to 10 hospitals. Incorrect payments included both overpayments and underpayments, for a net overpayment of $524,000.

We recommended that the State agency (1) refund to the Federal government $524,000 in net overpayments made to the 10 hospitals for CY 2011 and 2012; (2) review remaining payment calculations for the hospitals included in our review using final settled cost reports and additional auditable documentation to determine whether payment adjustments are needed, and refund any overpayments identified; (3) review the payment calculations for the 100 hospitals not included in our review using final settled cost reports and additional auditable documentation to determine whether payment adjustments are needed, and refund any overpayments identified; and (4) modify the Hospital Payment Calculation and Data Sources document to properly exclude bad debt/write-offs from the reported charity care. In written comments on our draft report, the State agency acknowledged that some original hospital EHR Incentive Payment calculations may have resulted in underpayments or overpayments. Our sample population was 134 hospitals at the time of our review. The State agency will include an additional 28 hospitals not included in our audit period. The State agency will recalculate 162 hospital EHR incentive payments using final settled cost reports and adjust accordingly.