This entry is part 38 of 48 in the series HIPAA Security Risk Analysis Tips

CMS announced in January, after a critical OIG audit report, that Eligible Providers, Eligible Hospitals and Critical Access Hospitals who have purchased and implemented an electronic health record (EHR) system and attested to meaningful use of that EHR may be subjected to an audit before they see an incentive payment. Here’s today’s big TIP — Learn the exact requirement for Risk Analysis documentation.  


HIPAA Risk Analysis Tip – Eligible Provider EHR Pre-Payment Audit Document Request

Several of our clients have learned that they have been chosen by The Centers for Medicare & Medicaid Services (CMS) that they will be audited before CMS will be making incentive payments.

As we report in a post entitled HIPAA Risk Analysis Tip – EHR Pre- and Post-Payment Audits, CMS has targeted 5 to 10 percent of those who attested to Meaningful Use in January 2013 to be audited before receiving any payments.

Providers who receive an EHR incentive payment for either the Medicare or Medicaid EHR Incentive Program potentially may be subject to an audit. Eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) should retain ALL relevant supporting documentation (in either paper or electronic format) used in the completion of the Attestation Module responses.

The specific CMS Eligible Provider EHR Pre-Payment Audit Document Request List covers the requirements related to a HIPAA Risk Analysis (Core Objective #15 for Eligible Professionals and Core Objective #14 for Eligible Hospitals and Critical Access Hospitals) along with other general information, core objective and menu set objectives/measures.

As a reminder, post-payment audits are not going away.  An additional 5 to 10 percent of physicians and others will be subject to post-payment audits, according to Holland. The audits are being conducted by Garden City, NY-based CPA firm Figliozzi and Company.

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We are often asked, “How do I go about selecting a reputable firm to complete a bona fide HIPAA Security Risk Analysis?”  This HIPAA Risk Analysis Buyer’s Guide Checklist is an easy-to-use tool to assist you in comparing alternative solutions and making your selection.

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Bob Chaput

CEO at Clearwater Compliance
Bob is the CEO and Founder of Clearwater Compliance. He has 25 years of experience in the Healthcare industry, and his experience includes managing some of the world’s largest HR, benefits and healthcare databases, requiring the highest levels of security and privacy. Mr. Chaput continues to expand and update his knowledge base on HIPAA-HITECH compliance through postgraduate study, earning professional certifications and participating in professional healthcare and other organizations.