Back in August a Medicare contractor, a wholly owned subsidiary of WellPoint, National Government Services received a contract to monitor Physician Incentive payments.  If you are a provider, this is the data systems imageunder CMS that will check and see if you are inline with Medicare for your incentive payments and ensure you are eligible and as we have read some reimbursements for 4 states may start soon.  The Office of the Inspector General appears to have monitoring this under their jurisdiction as well.

CMS Releases Plan for a Much Needed IT Infrastructure Upgrade With Computers, Data Systems And Those Updated Algorithms

For a brief summary the OIG will be monitoring technology enhancements, security breach policies, data privacy, smart card technology, payment errors, reviewing state Medicaid incentives for EHRS, safeguards to prevent erroneous payments, grant award systems (we need this for sure), integrity and availability of data, security controls for community health centers funded by HRSA Health IT grants, and a few other additional ARRA information systems. 

“The mission of the Office of Inspector General (OIG), as mandated by Public Law 95-452 (as amended), is to protect the integrity of Department of Health and Human Services (HHS) programs, as well as the health and welfare of the beneficiaries of those programs. The OIG has a responsibility to report both to the Secretary and to the Congress program and management problems and recommendations to correct them. The OIG's duties are carried out through a nationwide network of audits, investigations, inspections and other mission-related functions performed by OIG components.”


I hope their data systems and centers are up to date to handle this and that their own internal software, RAT-STATS (like the name) is up for the run. The OIG also allows you to download the software, which I have not had time to do, if you want to see what they use, nice bit of transparency here.  I’m sure it has been updated many times from the first version created in 1987. 

“RAT-STATS is the primary statistical audit tool used by the Office of Audit Services. Developed by the Regional Advanced Techniques Staff (RATS) in San Francisco, it has been used by the Office of Inspector General since the early 1970s. With the arrival of microcomputers, there was opportunity to move the statistical software from the mainframe timeshare systems.”


This looks like Visual Basic 6 like I used to write except I made prettier screens <grin>.  There’s a little sample in the screenshot below to say that all VB6 creations were not ugly and greySmile

What Does an Antiquated EMR (Electronic Record imageSystem) Look Like

The back end uses Microsoft Access, which even though it has been around for a while is still very functional and some SQL server data base programs contain Access data bases to export the data where additional queries are run and then pumped back in to SQL server so Access is not dead by any means. 


This stuff still works and actually allows for easy report making even though it’s still  VB 6 and most have moved on to C# and Dot Net applications, but to take and convert to Dot is a long process, or at least it for me.  Additionally I would look for the OIG to get some updated auditing software soon too so they are able to work with some of the newer software systems they have to audit, and again not that this doesn’t work but being ready for any technology and language today with data sets is where you have to be.  BD 

WASHINGTON – As the Centers for Medicare and Medicaid Services (CMS) prepares to upgrade its computer systems and begins to award incentive payments to eligible meaningful users of electronic health records, the Office of the Inspector General is positioning itself for its monitoring responsibilities. Medicare and Medicaid information systems and data security falls under the oversight of the OIG, as outlined in its work plan for 2011.

The Centers for Medicare and Medicaid Services (CMS), the largest healthcare payer in the country providing services to approximately 100 million beneficiaries and benefits totaling approximately $800 billion a year, released its plan for upgrading its computer and data systems on Dec. 23. The OIG is charged with monitoring those upgrades and also with overseeing the government stimulus program that will disburse billions to healthcare providers across the country who show meaningful use of electronic health records.

OIG to monitor Medicare, Medicaid IT upgrades, incentives | Healthcare IT News


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