The Department of Health and Human Services Office of Inspector General is making good on its promise to increase its focus on determining whether electronic health record use leads to Medicare fraud and abuse.
In its semi-annual report to Congress, released May 27, OIG highlights several new initiatives regarding EHRs, including identifying vulnerabilities in the Centers for Medicare & Medicaid Services' oversight of its contractors. OIG found that CMS had provided the contractors with only limited guidance on EHR fraud and raised concerns that the contractors could not identify copied and over documented information in an EHR. The agency also found that only one-quarter of hospitals studied had policies on the use of the EHR copy-and-paste feature to reduce the risk of billing fraud.
OIG reported on its recommendations regarding its findings, including that "HHS should ensure that audit logs are operational whenever EHR technology is available for updates or viewing.
"ONC and CMS should strengthen their collaborative efforts to develop a comprehensive plan to address fraud vulnerabilities in EHRs," the report continued. "[W]e recommend that CMS develop guidance on the use of the copy-paste feature in EHR technology."
OIG reported more than $3.1 billion in expected recoveries from its program integrity efforts, including $395 million in audit receivables and $2.83 billion in investigative receivables. It also brought 465 criminal and 266 civil actions in the past six months.
EHRs will continue to be a key focus area of the OIG, constituting a significant part of both its 2014-2018 strategic plan and its 2014 work plan. In April, OIG took the unusual step of terminating an advisory opinion originally in favor of a data exchange arrangement created by EHR vendor athenahealth.
To learn more:
- here's the semi-annual report (.pdf)