Hospital Must Pay Back $31 Million in Meaningful Use Money

The news just came out that Health Management Associates, Inc. (“HMA”) did not meet the meaningful use requirements necessary to receive the EHR incentive money and so they’ll have to pay back all of the money they’ve been paid by CMS. Here’s a portion of the article that details the amount they have to pay back:

The Company estimates that, between July 1, 2011 and September 30, 2013, it recognized as income HCIT incentive payments totaling approximately $31.0 million for the hospitals that did not meet the “meaningful use” criteria. Of these payments, the Company recognized as income approximately $8.3 million in 2011, approximately $17.3 million in 2012 and approximately $5.4 million in the first six months of 2013. On October 30, 2013, the Company withdrew the 11 hospitals from the HCIT programs and has repaid the majority of the funds to CMS. The Company is in the process of repaying the balance of the funds to the relevant state programs. The Company expects to re-enroll the hospitals in the HCIT programs and may be able to recoup some portion of the amounts repaid.

$31 million is a lot of meaningful use money to pay back. I’m still waiting for the details of why they failed their meaningful use attestation to come out. Although, I believe I read that the top management at HMA are gone from the company as well. So, it’s hard to say if this was a simple meaningful use mistake or if it was an intentional effort to game the EHR incentive and meaningful use system. In meaningful use stage 1 this is particularly easy to game since it was self-attestation.

I’m sad to say that I wrote about the potential of having to payback EHR incentive money previously. Plus, as I mention in that article, HMA will now be subject to the EHR penalties as well if they don’t get things corrected before those go in place. Of course, in my post I discuss organizations that make a good faith effort to attest to meaningful use. We’ll see if HMA made a good faith effort or not. Either way, this is an important warning for those organizations that aren’t doing everything they can do meet the meaningful use guidelines.

One EHR expert I spoke with about this situation said, “It’s not the last of such announcements I expect to come out in the next few months.” I’d only modify that to say “in the next few years.” If organizations had problems with meaningful use stage 1, you can be sure the problems will be multiplied with MU stage 2 and 3.

The problem is that if too many more stories like this come out it’s going to take a program that was suppose to incentivize EHR and make it into a weight around the neck of EHR implementations.

About the author

John Lynn

John Lynn

John Lynn is the Founder of, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • It is only a weight around your shoulders if you lie on your attestation.

    Lie / mis-inform / incorrectly input

    Whatever you want to call it.

    Most of what is attested is pulled straight from the EHR…
    So, either the numbers are being fudged…
    What I see the most of, the risk assessment is being fudged.

    Yes, docs are now receiving requests from HHS to prove the Security Risk Assessment was accomplished.
    If you didn’t, blamo, MU money gone.

    Playing dumb isn’t an option.

  • John Brewer,
    Don’t you think there could incidents where you thought the numbers were something, possibly your EHR vendor reports them as something, and then you later find out that it wasn’t accurate. This is particularly true in a hospital where you might be pulling from multiple systems.

    I’m not sure if this is the case with this organization, and I don’t condone lies or misinformation but there’s also a human element to this. I think the potential for this is even greater in MU stage 2.

  • John
    If you think that this is what turns Meaningful Use into
    “weight around the neck of EHR implementations” you have not been paying attention. This is ONE MORE “weight around the neck of EHR implementations” caused by meaningful use. Eventually one of these will be the last straw. The bankrupt hospitals and the Docs who have quit practicing already had their last straw, as have the 17% or so who have dropped out of meaningful use. Whose next?

  • Thanks for reporting this out John. Wow. I certainly hope your are wrong with your last statement….and that there will be very few , if any, additional stories like this one.

  • In March OCR reported on the initial set of meaningful use audits. Almost 80% of the audited practitioners did not do a meaningful use compliant risk assessment. If OCR carries out the promised audit of 10% of attesting providers, some 30,000 practitioners will have to return the stimulus funds. Some recoup demand letters have already been issued. This is a very fixable problem. While few providers are able to write their own assessments, at least two automated versions of the NIST meaningful use risk assessment protocols were demonstrated at the HIMSS show in Las Vegas. EMR vendors, with a very few exceptions, have been slow to adopt this technology and in some cases have mislead their customers. Beth, I am very much afraid that the stories are just starting.

  • Unfortunately, I believe this is just one of many to come. John B. is probably correct, it may have been that they fudged their Risk Analysis.
    If that is true, it is sad that the hospital most likely spent millions for a system, training, implementation, reporting etc. Only to see all their money evaporate because of something that would have been so easy to have completed.

  • Kevin,
    I’ve heard multiple people tell me that a rash of doctors are waiting to retire instead of doing meaningful use. They predicted that many of them have enough money saved and are old enough that they’ll just choose to retire. I’m sure some of this will happen. The question is just how many of them will do it and what will be the impact.

    That’s a good point about the audits. I hadn’t seen those numbers, but they’re really interesting. The challenge is that CMS doesn’t want to make organizations hate EHR and that many people returning their EHR incentive money could have that effect.

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