HP will be working directly with the EHR incentives program to verify accuracy with incentive payments which is part of the stimulus law. This is a good thing as someone outside the normal contractors is getting a chance to ensure audit trails and integrity of data is present. With the last announcement in this area a Medicare contractor who is a subsidiary of Wellpoint received a contract to work in this same area, different responsibilities.
Medicare Contractor Gets Deal to Monitor Physician Incentive Payments–Same Folks Earlier This Week Admonished For Not Doing Enough for Fraud Prevention?
If the WellPoint contract calls for the development of software then it appears we have a check and balance with HP who is not in the healthcare business as any type of provider and is in charge of quality. BD
Hewlett-Packard Enterprise Services has been awarded a task order worth up to $26 million by the Centers for Medicare & Medicaid Services (CMS) to maintain its Integrated Data Repository (IDR) and provide data quality services to improve the accuracy of Medicare payment data.
HP announced the deal last week and said the task order is in support of the agency's administration of the Medicare and Medicaid electronic health records (EHR) incentive programs created by the Health Information Technology for Economic and Clinical Health (HITECH) Act, which is part of the 2009 economic stimulus law.
The IDR database provides CMS with critical Medicare claims, provider and plan data, as well as data services to be used by the National Level Repository (NLR). CMS will use the NLR data to make Medicare incentive payment determinations for eligible healthcare professionals and hospitals under the EHR incentive programs.
As the NLR Data Quality contractor, HP will ensure that payment-grade data is provided to the NLR by establishing data reconciliation, audits, and reporting processes to validate IDR data.
HP Wins $26 Million Medicare Contract -- Hewlett-Packard -- InformationWeek
HP participation in the EHR program appears to be a good thing, getting an "independent" contractor to maintain the audit trail and ensure data integrity.ReplyDelete
The WellPoint contract, however, seems more troubling, having a contractor with an associated interest in the industry. The parent company WellPoint has a direct business relationship with providers, including negotiated contracts, and any potential access to provider data from the EHR program through the subsidiary should have immediately disqualified the company for this contract.
Anyone questioning this potential for abuse only needs to look at the recent United Healthcare settlement with providers, which demonstrates the potential conflicts caused by the parent-subsidiary relationship and how data manipulation can be used for benefit/profit.
I thought the same way and when you dig deep there's a lot of that going on in the payer side of healthcare with all the mergers and acquisitions taking place as a company may not be able to enter certain waters as the corporation but subsidiaries sometimes can and do.ReplyDelete