WASHINGTONreport
BY JOSEPH GOEDERT
A new report
recommends
that the Federal
Communications
Commission
make use of mobile technologies
a routine medical
best practice by
2017. The FCC in
June held a summit with industry
stakeholders to
examine opportunities and challenges of mobile
health products,
and created the
mHealth Task
Force to develop
recommendations. The FCC
is accepting a
number of its
recommendations, including:
consider an order
to streamline
the agency’s
experimental
licensing rules
to encourage
creation of wireless health device
“test beds,” and
consider an order
to permit provider
networks to jointly
apply for FCC
funds to increase
broadband capacity and implement EHRs.
FCC Goal:
Mobile Tech
is a Best
Practice
HHS to Hospitals:
Stop Using EHRs
to Game the
Billing System
Health and human ServiceS ecretary Kathleen Sebelius and attorney General eric holder (pictured right) have sent a let- ter to five hospital associations warning them against using
electronic health records to “game” the billing sys-
tem. What follows are excerpts from the letter to
the american hospital association, Federation
of american hospitals, association of academic
health centers, association of american medical
colleges and national association of Public hospi-
tals and health Systems:
“as leaders in the health care system, our nation’s hospitals have been at the
forefront of adopting electronic health records for use in coordinating care, im-
proving quality, reducing paperwork, and eliminating duplicative tests,” the gov-
ernment says. “Over 55 percent of hospitals have already qualified for incentive
payments authorized by congress to encourage health care providers to adopt
and meaningfully use this technology. used appropriately, electronic health re-
cords have the potential to save money and save lives.
according to the letter, there are troubling indications that some providers are
using ehr technology to game the system, possibly to obtain payments to which
they are not entitled. False documentation of care is not just bad patient care; it’s
illegal, the letter points out. “These indications include potential ‘cloning’ of medical records in order to inflate what providers get paid. There are also reports that
some hospitals may be using electronic health records to facilitate ‘upcoding’ of
the intensity of care or severity of patients’ condition as a means to profit with no
commensurate improvement in the quality of care.”
The government used the letter to underscore its resolve to ensure payment
accuracy and to prevent and prosecute health care fraud, citing dubious docu-
mentation practices that may be associated with an ehr. “a patient’s care in-
formation must be verified individually to ensure accuracy; it cannot be cut and
pasted from a different record of the patient, which risks medical errors as well as
overpayments,” the letter says. “The centers for medicare and medicaid Services
is specifically reviewing billing through audits to identify and prevent improperly
billing. additionally, cmS is ini-
tiating more extensive medical
reviews to ensure that providers
are coding evaluation and man-
agement services accurately.
This includes comparative bill-
ing reports that identify outlier
facilities. cmS has the author-
ity to address inappropriate
increases in coding intensity in
its payment rules, and cmS will
consider future payment reduc-
tions as warranted.”
The letter noted that the gov-
ernment will not tolerate health
care fraud. “The President initi-
ated in 2009 an unprecedented
Stimulus
EXCHANGE
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