The Bureau for Medical Services (BMS)is required to perform audits of PI payments.
Eligible Professionals
The Centers for Medicare and Medicaid Services (CMS) has set standards that eligible professionals (EPs) must meet in order to successfully demonstrate effective Meaningful Use (MU) of PI technology to receive an incentive payment under the Medicaid PI Incentive Program. We are responsible for confirming that EPs enrolled in the incentive program have successfully shown MU with regard to certified PI technology as part of our audit and oversight responsibilities. CMS has set standards that EPs must meet in order to successfully demonstrate effective Meaningful Use (MU) of PI technology to receive an incentive payment under the Medicaid PI Incentive Program. We are responsible for confirming that EPs enrolled in the incentive program have successfully shown MU with regard to certified PI technology as part of our audit and oversight responsibilities.
Attached for your reference are examples of the EP questionnaires to be completed along with accompanying instruction guides:
Eligible Professionals MU Stage 2 Audit Questionnaire
Eligible Professionals MU Stage 2 Audit Questionnaire Guide
Eligible Professionals MU Stage 3 Audit Questionnaire
Eligible Professionals MU Stage 3 Audit Questionnaire Guide
Eligible Hospitals
CMS has set standards that Eligible Hospitals (EHs) must meet in order to successfully demonstrate effective MU of PI technology to receive an incentive payment under the Medicaid PI Incentive Program. We are responsible for confirming that EHs enrolled in the incentive program have successfully shown MU with regard to certified PI technology as part of our audit and oversight responsibilities.
Attached for your reference is an example of the EH questionnaire to be completed:
Eligible Hospitals MU Stage 2 Audit Questionnaire
Eligible Hospital Stage 2 Audit Questionnaire Guide – Scheduled for Stage 1
Eligible Hospital Stage 2 Audit Questionnaire Guide – Scheduled for Stage 2
PI Audits
The providers (EPs and EHs) selected as part of the PI Audit will receive a cover letter from BMS along with an audit questionnaire prepared by BMS’s approved PI auditing contractor during the auditing period (usually in the fall) and will be required to return a completed questionnaire (along with any pertinent documentation) to BMS or the Auditing contractor via their information portal by the pre-determined due date. Providers selected for review not returning a completed and accurate questionnaire in the time allotted will be summarily determined as failing the audit.
West Virginia PI Audit FAQs