Meaningful Use Appeals Process – Meaningful Use Monday

Posted on January 30, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

If you are on of the 355 Eligible Providers who unsuccessfully attested to MU last year, CMS now offers an appeals process for both the Medicare and Medicaid programs. Here’s the section on appeals for EHR Incentive programs:

Starting December 1, 2011, CMS is accepting appeals for eligible professionals and eligible hospitals.

For general questions and for information on how to file an appeal, eligible professionals (EPs), eligible hospitals, critical access hospitals, Medicare Advantage Organizations, and Medicaid eligible hospitals may contact OCSQ’s designated appeal support contractor via the toll free number between 9 a.m. and 5 p.m. EST, Monday through Friday or via email.

1. Toll-free number: 855-796-1515
2. Email: OCSQAppeals@provider-resources.com

The Centers for Medicare & Medicaid Services (CMS), Office of Clinical Standards and Quality (OCSQ) is providing guidance on how to file an appeal.

If you click through to the How to File an Appeal link, it says that the final rule provides guidance and requirements for a Medicaid appeals process, but does not provide an appeals process for the Medicare EHR Incentive program. Although it also says that “CMS is currently implementing an appeals process for the EHR Incentive Program.”

It does also say that Provider Resources, Inc. (PRI) located in Erie, Pennsylvania was awarded the contract to handle the appeals process with the Office of Clinical Standards and Quality (OCSQ) overseeing the EHR incentive appeals process. Otherwise, it’s still pretty vague on the exact details of the appeals process other than the contact info.

I’ve read that beginning in February, appeal decisions will be posted on CMS’s Website under the Office of Clinical Standards and Quality. I hope that there’s some really good transparency in these postings so that those attesting to meaningful use in the future will be able to learn from people’s past mistakes.

If you’re someone that was denied and is going through the appeals process, I’d be interested to hear about your experience so we can share it with others that will need to do the same.