HHS Secretary Kathleen Sebelius and U.S. Attorney General Eric Holder sent a letter (pdf) to the five major hospital associations saying the federal government "will not tolerate healthcare fraud," and law enforcement agencies will pursue providers who try to "game the system" with new technologies.
The letter came one week after the Center for Public Integrity unleashed a series of investigative reports that found hospitals and other providers have bilked roughly $11 billion in Medicare funds over the past decade. The non-profit CPI discovered hospitals and other medical professionals have been billing Medicare for higher-paying codes, a process known as upcoding. Electronic health records could play a role in the upcoding if hospitals merely copy and paste patient data from record to record instead of entering in original, accurate data.
The letter was addressed to the American Hospital Association, the Federation of American Hospitals, the National Association of Public Hospitals and Health Systems, the Association of American Medical Colleges and the Association of Academic Health Centers. Ms. Sebelius and Mr. Holder noted that EHRs are a necessity for coordinating care, improving quality and reducing paperwork and duplicative tests, but they said EHRs should not be used to inflate their own payments or bill for services that were not provided.
The letter came one week after the Center for Public Integrity unleashed a series of investigative reports that found hospitals and other providers have bilked roughly $11 billion in Medicare funds over the past decade. The non-profit CPI discovered hospitals and other medical professionals have been billing Medicare for higher-paying codes, a process known as upcoding. Electronic health records could play a role in the upcoding if hospitals merely copy and paste patient data from record to record instead of entering in original, accurate data.
The letter was addressed to the American Hospital Association, the Federation of American Hospitals, the National Association of Public Hospitals and Health Systems, the Association of American Medical Colleges and the Association of Academic Health Centers. Ms. Sebelius and Mr. Holder noted that EHRs are a necessity for coordinating care, improving quality and reducing paperwork and duplicative tests, but they said EHRs should not be used to inflate their own payments or bill for services that were not provided.
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