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Health Law Checkup - September 2012
Government Warns Hospitals on Using Electronic Medical Records to Engage in Fraudulent Billing

09/28/2012

Government Warns Hospitals on Using Electronic Medical Records to Engage in Fraudulent Billing
By Paul J. Giancola

On September 24, 2012, the U.S. Department of Health and Human Services (HHS) and U.S. Department of Justice (DOJ) wrote a joint letter to the Chief Executive Officers of five prominent hospital associations. The letter warned that there are troubling indications that some providers are using electronic medical records (EMR) to “game the system, possibly to obtain payments to which they are not entitled (emphasis added).” The letter provided specific examples of providers using EMR for “upcoding” the intensity or severity of a patient’s condition – to inflate what they get paid – “with no commensurate improvement in the quality of care.”

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