By Katie Wike, contributing writer
According to a new study, the belief that electronic health records would aid providers in scamming Medicare is unfounded.
In 2012, The New York Times reported the Obama administration had issued a warning it would not tolerate attempts to fraud Medicare or Medicaid. A letter from the administration read, in part, “Electronic health records have the potential to save money and save lives.”
The letter also stated, however, “There are troubling indications that some providers are using this 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.
“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.”
Recently, a study published on Health Affairs claims to have found that EHRs do not in fact prompt hospitals to overbill Medicare. EHR Intelligence reports the study found cases of fraudulent use of EHRs are not widespread enough to prompt a policy change.
“There have been a lot of anecdotes and individual cases of hospitals using electronic health records in fraudulent ways. Therefore there was an assumption that this was happening systematically, but we find that it isn’t,” said study author Julia Adler-Milstein, University of Michigan assistant professor of information.
iHealth Beat explains, “Researchers examined whether U.S. hospitals using EHRs had greater increases in the severity of patients’ conditions and in overall Medicare billing than hospitals that had not yet adopted EHRs.” Adler-Milstein and Ashish K. Jha, Harvard professor of public health, found that there was little difference in the Medicare billing rate between hospitals that had adopted EHRs and those that hadn’t.
“To my surprise, we found nothing,” says Jha in an NPR and Kaiser Health article. “We found that electronic health records didn’t really change billing practices at all.”
