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HHS, Justice Department Warn Hospitals on EHR-Related Payment Fraud

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The Obama administration on Monday issued a stern letter to the nation's hospitals (PDF) that warned that HHS and the Justice Department will crack down on providers that misuse electronic medical records to bill for unprovided services.

In a letter Monday to five healthcare provider associations, HHS Secretary Kathleen Sebelius and U.S. Attorney General Eric Holder said there have been indications that some hospitals use electronic health records to "game the system" to their advantage. For instance, facilities might "clone" medical records to inflate what providers are paid or "upcode" the care provided as a way to make a profit. Consequently, the CMS is specifically reviewing billing through audits to identify and help prevent improper billing.

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Source: ModernHealthcare.com


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