Sometimes there's so much attention paid to the Centers for Medicare & Medicaid Services and the Medicare Meaningful Use program that we tend to overlook the Medicaid side. But we shouldn't. The Medicaid incentive program--and more specifically, its audit potential--just catapulted into new territory.
Providers have been expressing their disappointment that the final Meaningful Use flexibility rule, released Aug. 29, saying it offers scant relief, is "too little too late" and puts the very future of the program "in question."
Once again, the Meaningful Use program is suffering from a disconnect between aspiration and reality. This time it's patient engagement.
There's a well-known adage in business that 10 percent of people will never steal, embezzle or commit fraud; 10 percent will always steal, embezzle or commit fraud when they can; and 80 percent will do it under certain circumstances when given the opportunity.
That might finally explain what's occurring with electronic health records and billing fraud.
The Centers for Medicare & Medicaid Services' 2015 provider payment rules, many of which have been released this month, are receiving a lot of attention. But I'm surprised that one of the most consistent themes throughout them--"EHR creep"--has received very little publicity.
I fear the security of patient information in electronic health records has gone from bad to worse. First we learn that more people are withholding information from their providers who use EHRs because they fear the systems won't keep their information confidential. Now we learn that they're right.
I hope I'm not the only person who finds the results of a study recently published in the Journal of the American Medical Informatics Association on patient perceptions of electronic health record users troubling.
The Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT's proposed rule offering some flexibility for attesting to Meaningful Use in 2014 may be one of the few occasions where a rule relating to the program has been met with open arms. But deeper dive reveals a detail that I find particularly interesting: the Medical Group Management Association's suggestion that CMS has overstepped its regulatory authority in Stage 2.
Why is there disconnect between laboratories and electronic health records?
It turns out that the providers may have been right all along: Simply using an EHR does not lead to fraudulent billing.