OIG: Report follows up on audit on EHR link to Medicare fraud and abuse
In its semi-annual report, the Department of Health & Human Services Office of Inspector General (OIG) addressed whether use of EHRs leads to Medicare fraud and abuse.
The report addresses a December 2013 OIG audit that found most hospitals lack policies governing the use of copying and pasting health information into EHRs, which could lead to fraud and abuse. That report was based on a voluntary survey of all 864 hospitals that had received EHR subsidy payments as of March 2012.
According to the audit, 24 percent of hospitals reported having a policy regarding the improper use of copy-and-paste functions within EHR systems.
"Although EHR technology may make it easier to commit fraud, the Centers for Medicare & Medicaid Services (CMS) and its contractors have not adjusted their practices for identifying and investigating fraud in EHRs," OIG said in its semi-annual report. "CMS had provided limited guidance to Medicare contractors on EHR fraud vulnerabilities."
The new report also found that few Medicare contractors had different practices for reviewing EHRs and paper records and Medicare contractors were unable to detect copied and over-documented EHR data.
Based on its findings, OIG recommended that "HHS should ensure that audit logs are operational whenever EHR technology is available for updates or viewing. [The Office of the National Coordinator for Health IT] and CMS should strengthen their collaborative efforts to develop a comprehensive plan to address fraud vulnerabilities in EHRs. [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. The agency brought 465 criminal and 266 civil actions in the past six months.
The report states that EHRs will continue to be a key focus area of the OIG, serving as a significant part of both its 2014-2018 strategic plan and its 2014 work plan.
Read the complete semi-annual report.
Editor
Editor Beth earned a bachelor’s degree in journalism and master’s in health communication. She has worked in hospital, academic and publishing settings over the past 20 years. Beth joined TriMed in 2005, as editor of CMIO and Clinical Innovation + Technology. When not covering all things related to health IT, she spends time with her husband and three children.