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Program Integrity & Audit

The Division of TennCare is required to ensure the integrity and effectiveness of Tennessee’s Medicaid EHR Incentive Payment Program. In order to fulfill this requirement, TennCare has developed processes for both prepayment verification and post payment audits of provider attestations. Upon submitting an attestation, the provider, or the person attesting on behalf of the provider, affirms that the attestation is true, accurate, and complete, to the best of his/her knowledge and belief.

Prepayment Verifications

TennCare has implemented stringent prepayment verification procedures to ensure the accuracy of the information submitted as part of the EHR attestation. Many aspects of the eligibility requirements and achievement of meaningful use are verified prior to payment of any EHR incentive. Complete and correct attestations are paid within 30-45 days. Attestations identified by the prepayment verification process as being incomplete or incorrect are electronically returned to the provider with detailed guidance and instructions, where applicable, to address the issue(s). Follow the links below for information and resources to facilitate successful participation and attestation.

If you have questions about the prepayment verification process, contact: TennCare.EHRIncentive@tn.gov regarding eligibility requirements. 

Post Payment Audits

TennCare’s Audit & Investigations has contracted with the public accounting firm Myers and Stauffer LC to perform post-payment audits for the EHR Incentive Program, starting with payments awarded in the 2015 Program Year. Although the vendor is assuming the responsibility for performing such audits, the audits will continue to be conducted under TennCare’s oversight.

Providers/Hospitals who have been randomly selected for post-payment audits will be contacted from employees of Myers and Stauffer. The notices will be sent from the domain mslc.com. To ensure that you receive audit communications from Myers and Stauffer, please add mslc.com to your email client’s list of accepted or safe senders/recipients.

Information collected will be held in strict confidence in compliance with all applicable policies, requirements, regulations, and statutes. Myers and Stauffer has safeguards to prevent use or disclosure of information obtained during the course of the engagement. Myers and Stauffer will report the results of their work to TennCare.

Failure to cooperate with Myers and Stauffer may result in recovery of some or all of the EHR incentive payment.

If you have any questions regarding Medicaid EHR post-payment audits, please email InternalAudit.TennCare@tn.gov.