Hospitals respond to feds’ warning about electronic records, billing fraud

Hospitals respond to feds’ warning about electronic records, billing fraud

Hospital industry groups responded Tuesday to the warning issued by Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder, saying that the federal government shares part of the blame, because it hasn’t provided hospitals adequate guidance on billing for common services.

Politico: Hospitals: Feds Share Billing Blame

A threat from Health and Human Services and the Department of Justice to crack down on questionable Medicare billing has drawn a fairly strong rejoinder from two major hospital groups who say federal regulators deserve part of the blame. The Association of Academic Health Centers sent a letter Tuesday to HHS and DOJ echoing complaints from the American Hospital Association that the industry doesn’t have adequate guidelines on billing for some of the most common services. The hospitals said they had repeatedly asked for such information to no avail -; and that the problem has gotten worse with the proliferation of electronic health records (Norman and Millman, 9/26).

Modern Healthcare: Groups Push Back On Federal Warning About EHRs And Billing Fraud

If hospitals’ bills to federal healthcare programs are increasing through the use of electronic health records, it may be because of improvements in documentation and a lack of national standards for gauging the intensity of some treatments, industry groups asserted in response to a critical letter from two federal agency chiefs. Healthcare groups issued those reactions swiftly after receiving a letter Monday from HHS Secretary Kathleen Sebelius and U.S. Attorney General Eric Holder that publicly warned hospitals it is illegal to use electronic health records to inflate bills through “false documentation.” (Carlson, 9/25).

Meanwhile, The Wall Street Journal reports on how a popular procedure is emerging as a driver of Medicare costs -

The Wall Street Journal: Rise In Knee Replacements Boosts Federal Health Costs

The number of knee replacements paid for by Medicare has more than doubled over the past two decades, according to a study published Tuesday that suggests the popular procedure is emerging as an important driver of costs for the nation’s health-care system (Wang, 9/25).

http://www.kaiserhealthnews.orgThis article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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